Accidental carotid artery injury caused by a horse rope.

A 37 year old woman who had bred horses for more than 20 years was leading two horses in a horse corral. One horse bolted and the lead rope wrapped around her neck. Four hours after the accident, she developed sudden aphasia, right facial palsy, and right arm weakness. Conventional and magnetic resonance angiography showed complete traumatic occlusion of the left common carotid artery due to thrombosis at the C6/7 level. There was good collateral flow from the other side. The patient was maintained on heparin followed by warfarin and recovered completely by the third day. This case shows the importance of suspecting vascular injury and thrombosis after trauma to sites of major vessels.