Perforating injuries of the soft palate in childhood are generally uncomplicated. Such simple injuries may however be accompanied by far reaching consequences. A resulting thrombosis of the A. carotis interna in a child after a perforating injury of the soft palate showed how difficult diagnosis may be. Perforating injuries of this type are relatively common, complications are relatively rare. Furthermore the injury may be followed by a lengthy symptom-free interval. No further diagnostic procedure seems necessary during this interval than clinical examination. The belated appearance of central symptoms comes at a time where all to often diagnosis and therapy can not influence the final outcome.