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Vertebral artery occlusion associated with blunt traumatic cervical spine injury

Youhei Nakamura1, Kenji Kusakabe2, Shota Nakao2

  • 1Department of Neurosurgery Rinku General Medical Center Osaka Japan and.

Acute Medicine & Surgery
|August 19, 2021
PubMed

Insights

Endovascular embolization effectively prevents stroke in patients with severe vertebral artery injury and unstable cervical spine injury. This treatment, performed before surgery, offers a viable option for managing these complex traumatic injuries.

Area of Science:

  • Neurosurgery
  • Vascular Surgery
  • Trauma Surgery

Background:

  • Blunt traumatic cervical spine injuries can lead to vertebral artery injury, increasing the risk of severe cerebellar and brain stem infarction.
  • Current treatment guidelines for vertebral artery injury to prevent stroke are not well-established.
  • Endovascular embolization has been explored for managing complex cerebrovascular injuries in conjunction with spinal trauma.

Purpose of the Study:

  • To validate the clinical course of vertebral artery injury (VAI) in patients with traumatic cervical spine injury.
  • To specifically evaluate the efficacy of endovascular treatment for Grade IV VAI patients before surgical intervention.

Main Methods:

  • Retrospective analysis of patients diagnosed with traumatic cervical spine injury between January 2015 and April 2018.
  • Selection of patients with complicating vertebral artery injury.
  • Examination of patient characteristics, treatment details, and stroke complications.

Main Results:

  • 15 out of 89 patients (16.7%) with traumatic cervical spine injury had associated vertebral artery injury.
  • Vertebral artery injury was classified as Grade IV in 12 patients, with nine requiring spinal surgery.
  • All nine patients undergoing surgery received endovascular therapy prior to spinal fixation, and none experienced a stroke.

Conclusions:

  • Endovascular embolization of vertebral artery occlusion is a potential treatment option for preventing stroke in patients with unstable cervical spine injury.
  • This approach, when performed before open reduction and fixation surgery, demonstrates promising results in stroke prevention.
Abstract

Keywords:
Cervical spine fractureVAIendovascular therapygrade IVprevention of stroke

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