[Life-threatening bleeding due to craniofacial injury treated by ligature of the external carotid artery].

Life-threatening bleeding following craniofacial injury is rare. The rich collateral circulation between external and internal carotid arteries complicates the problem of controlling haemorrhage. We report the case of a 63-year-old man who presented a life-threatening haemorrhage following maxillofacial trauma and a severe head injury with subdural haematoma requiring neurosurgical evacuation. Although we had an interventional radiology unit, facial haemostasis was achieved by an unilateral ligation of the external carotid artery. There were three reasons behind our decision: multiple bleeding excluding selective endovascular embolization, efficiency and speed of the ligation of the external carotid, only one place for this cephalic surgery in two phases (neurosurgery and neck surgery). The role of ligation of the external carotid artery for life-threatening bleeding following facial injury is discussed.