{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T12:12:40Z","timestamp":1789560760913,"version":"build-2803163510"},"reference-count":14,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,8,24]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:p>Animal attack related penetrating injuries of the neck are important causes of stroke due to carotid artery dissection and subsequent watershed infarcts. Early vascular imaging, timely antithrombotic therapy and multidisciplinary management are critical to optimising better outcomes. A female in her fourth decade presenting with altered sensorium, hemiplegia and hypotension following a tiger attack on the neck and subsequent carotid dissection. In this case report, we discuss the clinical state, work-up and follow-up outcome of this rare stroke case due to tiger attack. Clinicians should maintain a high index of suspicion of vascular injury in penetrating neck trauma for early recognition and prompt management.<\/jats:p>","DOI":"10.1136\/bcr-2026-272728","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T12:00:12Z","timestamp":1789560012000},"page":"e272728","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Stroke due to penetrating neck injury inflicted by tiger attack"],"prefix":"10.1136","volume":"19","author":[{"given":"Anadi","family":"Mishra","sequence":"first","affiliation":[{"name":"Neurology, King George Medical College, Lucknow, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harish","family":"Nigam","sequence":"additional","affiliation":[{"name":"Neurology, King George Medical College, Lucknow, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7016-2361","authenticated-orcid":false,"given":"Rajesh","family":"Verma","sequence":"additional","affiliation":[{"name":"Neurology, King George Medical College, Lucknow, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2304-2177","authenticated-orcid":false,"given":"Rajarshi","family":"Chakraborty","sequence":"additional","affiliation":[{"name":"Neurology, King George Medical College, Lucknow, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ankit","family":"Khetan","sequence":"additional","affiliation":[{"name":"Neurology, King George Medical College, Lucknow, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0764-1591","authenticated-orcid":false,"given":"Shazia","family":"Durdana","sequence":"additional","affiliation":[{"name":"Neurology, King George Medical College, Lucknow, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"key":"2026091605000854000_19.9.e272728.1","unstructured":"Goodfriend SD , Tadi P , Koury R . Carotid artery dissection. In: StatPearls. Treasure Island (FL): StatPearls Publishing, 2022."},{"key":"2026091605000854000_19.9.e272728.2","doi-asserted-by":"crossref","DOI":"10.5812\/archneurosci.26670","article-title":"Cervical Artery Dissection: A Review of the Epidemiology, Pathophysiology, Treatment, and Outcome","volume":"2","author":"Blum","year":"2015","journal-title":"Arch Neurosci"},{"key":"2026091605000854000_19.9.e272728.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2015.09.368"},{"key":"2026091605000854000_19.9.e272728.4","doi-asserted-by":"crossref","first-page":"109940","DOI":"10.1016\/j.ijscr.2024.109940","article-title":"Carotid artery penetrating trauma: Report of 4 cases and literature revision","volume":"121","author":"Mu\u00f1oz","year":"2024","journal-title":"Int J Surg Case Rep"},{"key":"2026091605000854000_19.9.e272728.5","first-page":"12758","article-title":"Case Report A case of internal carotid artery dissection with delayed cerebral infarction caused by penetrating trauma","volume":"11","author":"Xu","year":"2018","journal-title":"Int J Clin Exp Med"},{"key":"2026091605000854000_19.9.e272728.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2011.06.024"},{"key":"2026091605000854000_19.9.e272728.7","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.29.12.2646"},{"key":"2026091605000854000_19.9.e272728.8","first-page":"581","article-title":"The Clinical Features of Dissection of the Cervical Brain-Supplying Arteries","volume":"119","author":"Arning","year":"2022","journal-title":"Dtsch Arztebl Int"},{"key":"2026091605000854000_19.9.e272728.9","first-page":"69","article-title":"Penetrating and blunt trauma to the neck: clinical presentation, assessment and emergency management","volume":"12","author":"Verdonck","year":"2016","journal-title":"Acta Oto-Rhino-Laryngol Belg -Brussel"},{"key":"2026091605000854000_19.9.e272728.10","doi-asserted-by":"crossref","first-page":"866","DOI":"10.2214\/AJR.14.14161","article-title":"Vascular Injuries to the Neck After Penetrating Trauma: Diagnostic Performance of 40- and 64-MDCT Angiography","volume":"205","author":"Bodanapally","year":"2015","journal-title":"Am J Roentgenol"},{"key":"2026091605000854000_19.9.e272728.11","doi-asserted-by":"crossref","first-page":"63","DOI":"10.4103\/0022-3859.74296","article-title":"\u201cBull on neck\u201d: dissection of right common carotid artery","volume":"57","author":"Gupta","year":"2011","journal-title":"J Postgrad Med"},{"key":"2026091605000854000_19.9.e272728.12","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/j.ejvs.2024.12.018","article-title":"Editor\u2019s Choice -- European Society for Vascular Surgery (ESVS) 2025 Clinical Practice Guidelines on the Management of Vascular Trauma","volume":"69","author":"Wahlgren","year":"2025","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"2026091605000854000_19.9.e272728.13","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e3181cb43da"},{"key":"2026091605000854000_19.9.e272728.14","doi-asserted-by":"crossref","first-page":"XXXIX","DOI":"10.1177\/23969873211046475","article-title":"ESO guideline for the management of extracranial and intracranial artery dissection","volume":"6","author":"Debette","year":"2021","journal-title":"Eur Stroke J"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2026-272728","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T12:00:17Z","timestamp":1789560017000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2026-272728"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":14,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9,16]]},"published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1136\/bcr-2026-272728"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2026-272728","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]}}}