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Arrow injury to the face

Case contributed by Michael P Hartung
Diagnosis certain

Presentation

Shot in the face by an arrow.

Patient Data

Age: 25 years
Gender: Male
ct

Penetrating arrow injury through the left mandibular ramus, with tip of the arrow and air locules in the left parapharyngeal space. 

Although it is challenging to confidently see without the ability to window/level, the arrow tip just missing the upper cervical left ICA (see intermediate window images), as it courses anterior to the arrow tip. The IJV also appears spared and is compressed posteriorly. 

Photo

Arrow example.

Case Discussion

Penetrating arrow injury. The tip of the arrow barely misses the cervical ICA as it courses through the left parapharyngeal space, avoiding a devastating vascular injury. 

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