Abstract
A 34 year old man sustained blunt trauma to his neck following repeated non-fatal manual neck strangulation. After a few hours he developed altered sensorium and dysphasia and 6 hours later he deteriorated further and was brought to the emergency department. On examination he had a dense right sided hemiplegia aphasia. Plain CT scan of the head should a large hypodense area in the vascular territory of the left middle cerebral artery suggestive of infarction. CT angiogram of the neck and head showed thrombosis of the right common carotid and internal carotid artery with total occlusion of the left middle cerebral artery stem. He was treated conservatively and improved partially. Problems associated with carotid artery thrombosis in the setting of blunt head and neck trauma are discussed.