Traumatic vertebral artery dissection and cerebral infarction following head and neck injury with a lucid interval

Two patients with cerebral infarction following head and neck injury who showed a lucid interval are presented.

A 70-year-old male showed infarctions in the cerebellum bilaterally and the right hypothalamus on the sixth day after an injury with no fracture of the cervical spine, and bilateral dissection of the vertebral arteries was diagnosed. A 74-year-old male showed infarctions in the territory of the right posterior cerebral artery and posterior inferior cerebellar artery 2 days after injury with fractures of the cervical spine (C2 and C3) and was diagnosed as having artery-to-artery embolism based on dissection of the right vertebral artery.

Head and neck injury is a very common presentation in the emergency department. Three-dimensional computed tomography angiography is an effective screening imaging method for vertebral artery dissection that should be carried out on arrival in every patient with fracture of the cervical spine, and even considered in doubtful cases with no fracture.