The Clandestine Slayer: A Case Report on Carotid Artery Injuries in Traumatic Brain Injury

Abstract Traumatic carotid artery injury is a rare yet potentially fatal complication of head and neck trauma. Often masked by primary brain injury, it may remain undiagnosed until the onset of devastating neurological consequences. We present two contrasting cases of traumatic brain injury with carotid artery injury—one where the injury was missed initially, leading to malignant infarction and death, and another where timely detection resulted in a favorable outcome. These cases underscore the importance of heightened clinical suspicion and standardized screening for carotid artery injury in specific trauma patterns, especially in patients presenting with high-risk mechanisms or unexplained neurological deterioration.