Vertebral artery dissection after iatrogenic cervical subcutaneous emphysema

Area of Science:

• Vascular Surgery
• Neurology
• Cardiology

Background:

• Vertebral artery dissection (VAD) is a significant cause of stroke in young adults.
• VAD is often linked to minor trauma, including neck movements and direct injury.
• Cardiac transplant patients may face unique post-operative complications.

Observation:

• A patient developed spontaneous VAD after chest tube removal post-cardiac transplant.
• Extensive subcutaneous emphysema was observed, tracking into the neck.
• The VAD was linked to mediastinal tube removal and subsequent emphysema.

Findings:

• Subcutaneous emphysema can propagate through fascial planes to the neck.
• This emphysema may be associated with spontaneous vertebral artery dissection.
• The case presents an uncommon mechanism for VAD.

Implications:

• Recognizing subcutaneous emphysema as a potential indicator for VAD is crucial.
• Understanding this complication can improve management strategies for post-cardiac transplant patients.
• Further research into the pathophysiology of VAD secondary to emphysema is warranted.