Advanced Trauma Life Support (ATLS) 2025 – 400 Free Practice Questions to Pass the Exam

A pulsatile hematoma is a significant indicator of potential vascular injury, particularly in cases of neck trauma. This type of hematoma reflects an injury to a blood vessel, where blood leaks out of the vessel and accumulates in the surrounding tissues. The pulsatile nature suggests that the hematoma is actively communicating with an artery, which could mean there's an arterial injury, such as a laceration. In the context of neck trauma, where vascular structures such as the carotid artery and the jugular vein are at risk, the presence of a pulsatile hematoma necessitates urgent evaluation and management to prevent significant hemorrhage or complications like stroke.

In contrast, a hoarse voice may indicate laryngeal injury but isn’t specific to vascular damage. Subcutaneous emphysema often suggests air leakage from a respiratory or gastrointestinal tract injury and does not directly indicate vascular compromise. Severe dysphagia could signal esophageal injury but also does not directly point to a vascular problem. Thus, the presence of a pulsatile hematoma clearly stands out as a critical sign of potential vascular injury in a patient with neck trauma.