[Cerebral artery occlusion due to blunt cervical trauma]

Three cases are reported in which cerebral infarction developed due to blunt cervical trauma. All of these patients had external signs of cervical trauma and presented focal cerebral ischemic symptoms. Cerebral angiography demonstrated characteristic findings in each case. The first case: A 27 year-old man developed left hemiparesis four days after hitting his neck against a bed rail. Cerebral angiography showed complete occlusion of the right extracranial internal carotid artery 1.5 cm distal to its origin and emboli in distal branches of the right middle cerebral artery. He was treated conservatively. The second case: A 32 year-old man developed disturbance of consciousness with motor aphasia and right hemiparesis a few hours after hitting his chest and neck against baggage hanging from a crane. Cerebral angiography showed complete occlusion of the left middle cerebral artery and no abnormalities of the left internal carotid artery. He was treated with STA-MCA anastomosis two weeks after the accident. The third case: An 84 year-old man, who failed in a suicidal hanging, was semicomatose on admission and had right hemiparesis. Computed tomography demonstrated massive cerebral infarction of the territory of both anterior and left middle cerebral arteries. Cerebral angiography showed linear shadow defect of the left extracranial internal carotid artery corresponding with the site of the ligature. He was treated conservatively. From these angiographic findings, it was thought that intimal tear, intramural hematoma, vasospasm of the internal carotid artery and emboli given might bring about cerebral infarction. In such cases of blunt cervical trauma, cerebral angiography should be undertaken as soon as possible if focal cerebral ischemic symptoms can be seen.(ABSTRACT TRUNCATED AT 250 WORDS)