Fracture of the Petrous Carotid Canal

A 23-year-old male motorcyclist experienced blunt head trauma with loss of consciousness, headache and vomiting, epistaxis right otorrhagia after a collision motor vehicle. Fractures involving the parietal temporal bones, as well acute subdural subarachnoid hemorrhage were identified on cranial facial CT scan. On independent evaluation imaging study, subtle but distinct fracture line in skull base petrous carotid canal was identified. (Figure 1) The patient subsequently underwent angiography to evaluate for any injury internal artery. In this examination, good opacification arteries their branches noted, no evident aneurysm, arteriovenous malformation or fistula formation.
 patients bone fractures, most commonly encountered complications are: tympano-ossicular causing conductive hearing loss, cochlear vestibular sensorineural vertigo, nerve paralysis, fractures tegmen posterior fossa plate cerebrospinal fluid leaks.1 other hand, intratemporal portion artery has been described rare complication such may be overlooked.1 However, its potentially devastating life-threatening sequelae necessitates purposeful intentional presence. These include brain ischemia from arterial dissection complete vascular occlusion, exsanguinating pseudoaneurysms, formation carotid-cavernous fistulas.2 incidence involvement reported around 24%, 11% group developing injuries.3 As such, presence is an indication MR further artery.4