# Penetrating Neck Injury With Common Carotid Artery Involvement: A Case Report

## TL;DR

A 23-year-old man survived a nail gun injury to his carotid artery through timely surgery and proper care.

## Contribution

This case report adds a rare clinical example of successful treatment of a common carotid artery injury from a nail gun.

## Key findings

- The patient was hemodynamically stable with no neurological deficits upon arrival.
- Surgical repair of the carotid artery intimal injury was successful with no postoperative complications.
- Dual antiplatelet therapy was used post-surgery to reduce thrombotic risks.

## Abstract

Penetrating neck injuries often involve vascular injuries, including the carotid arteries, posing significant morbidity and mortality risks. This report presents a case of a 23-year-old male who sustained a penetrating neck injury from a nail gun, specifically affecting the common carotid artery (CCA). Upon arrival at the emergency department, the patient exhibited hemodynamic stability, with no active bleeding or neurological deficits. Initial imaging, including CT angiography (CTA) of the neck, revealed a metallic foreign body near the CCA and air foci suggestive of a muscle tear. Following resuscitation per Advanced Trauma Life Support (ATLS) protocols, the patient underwent emergency neck exploration. Surgical findings included a small hematoma and an intimal injury to the CCA, which was repaired using sutures after nail extraction. Postoperatively, the patient showed no complications and was discharged in good condition, receiving dual antiplatelet therapy to mitigate thrombotic risks.

This case highlights the critical importance of timely assessment and intervention in managing neck vascular injuries, particularly those involving the carotid artery. Adhering to ATLS guidelines, using imaging for accurate diagnosis, and employing appropriate surgical techniques can significantly improve patient outcomes. Early recognition and management remain vital to enhancing prognosis and reducing mortality associated with these complex injuries.