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In another case, a patient with anastomotic thrombosis underwent reoperation to restore injured CCA blood flow three days after wounding, and a total regression of neurologic deficit was observed postoperatively. The maintenance of cerebral perfusion is the factor most closely related to the successful repair of CA injury, rather than the presence of neurologic damage and its duration. Thrombectomy from the distal Furin portion of the ICA is always associated with a high risk of thrombus avulsion and its migration into cerebral vessels.1 Therefore, we believe that CA repair should not be indicated in extensive distal-ICA thrombosis. There do not appear to be sufficient reasons for the ICA reconstruction in the cases of injury to the skull base when there are significant technical problems.15 It seems advisable to use endovascular management of zone III injuries, selleck kinase inhibitor and zone I injuries as well, when the access to major arteries is difficult and traumatic.17?and?18 In this case, a diagnostic angiography could turn to a therapeutic one. However, we consider this type of management is to be of value in the case of isolated injury or blunt trauma. The open access is considered to be the most effective to deal with the consequences of zone II injuries, which occur the most frequently. Therefore, we propose that, in spite of the development in endovascular management used in extracranial artery injuries, the open access is a priority method, especially in the forward hospitals during combat operations. The risk of stroke development in patients with CA injury is known to reach 50%; hence, TS to preclude ischaemic damage is the only effective method of stroke prevention.1 SP measurement is one of the methods Enzalutamide nmr that allows to make indications for TS of the CA. This is a simple, quick and efficient procedure in the assessment of collateral blood supply to the brain under the condition of induced ischaemia.19 We agree with DeLaurentis et?al.19 and Cherry Jr. et?al.20 who demonstrated SP measurement in the ICA to be a rather reliable method of assessment of Willis arterial circle competency and compensatory capacity. In the majority of patients, there is a well-developed collateral blood flow, which allows the vascular repair to be carried out without TS.21 Many authors consider SP findings