Traumatic carotid artery dissection without head or neck trauma: a case report following thoracoabdominal crush injury.

A previously healthy 41-year-old woman was admitted after being crushed beneath a forklift from the chest to the lower extremities, presenting with traumatic asphyxia. Initial evaluation revealed no apparent trauma to the head or neck, but multiple fractures from the chest to the lower extremities were diagnosed. The patient underwent emergent thoracoabdominal surgery with subsequent clinical improvement. However, 4 days after the accident, anisocoria developed, and neuroimaging confirmed ischemic stroke due to traumatic carotid artery dissection. Anticoagulation and lipid-lowering therapy were initiated, and the patient successfully underwent the remaining orthopedic procedures without hemorrhagic complications. This report emphasizes that traumatic carotid artery dissection may occur even in the absence of concomitant cervical or cranial injuries, highlighting the importance of considering vascular injury in patients with severe trauma regardless of the mechanism of injury.