Tehran University of Medical Sciences Frontiers in Emergency Medicine 2717-3593 4 4 2019 11 13 e94 e94 EN Maryam Khodayar Clinical Research Development Unit, Imam Hossein Hospital, Shahroud University of Medical Sciences, Shahroud, Iran Mehran Sotoodehnia Department of Emergency Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Amir Noyani Clinical Research Development Unit, Imam Hossein Hospital, Shahroud University of Medical Sciences, Shahroud, Iran. Hossein Sheidaie Clinical Research Development Unit, Imam Hossein Hospital, Shahroud University of Medical Sciences, Shahroud, Iran. Seyedmeysam Yekesadat Clinical Research Development Unit, Imam Hossein Hospital, Shahroud University of Medical Sciences, Shahroud, Iran. 2019 10 04 2019 11 09 Introduction: This case emphasizes on the importance of detecting thrombosis and carotid artery injuries and the need for rapid treatment of blunt neck traumas. Case presentation: A 43-year-old male motorcyclist rider, rode into a rope and suffered blunt neck trauma. At admission to the emergency department (ED), he was fully conscious with Glasgow coma scale of 15. The biochemical tests and X-rays were normal, but initial examination revealed paresthesia in the right-hand fingertips, which exacerbated over the first 24 hours of admission. Doppler ultrasound of the neck arteries and computed tomography (CT) angiography reports showed thrombosis of the right common carotid artery, which spread to the right subclavian and vertebral arteries. Treatment was initiated with heparin injection followed by daily administration of oral warfarin, and seven days later, symptoms were relatively improved. Conclusion: Considering possible vascular injuries following blunt neck trauma should be kept in mind when dealing with such patients, and necessary physical examination required to rise the impression. By reviewing the literature, it seems that although CT angiography is usually used in screening carotid injuries, this modality appears to have poor sensitivity in this regard, and digital subtraction angiography (DSA) is still considered the gold standard for detecting carotid artery injury. https://fem.tums.ac.ir/index.php/fem/article/view/278 https://fem.tums.ac.ir/index.php/fem/article/download/278/243