Delayed cortical blindness and recurrent quadriplegia after cervical trauma

In a retrospective, single-patient case report, we report on a 56-year-old woman with delayed cortical blindness and recurrent quadriplegia after a comminuted C1 burst fracture and a type II odontoid fracture. The vertebral artery is susceptible to injury during trauma to the cervical spine. The resulting vascular compromise may be responsible for a variety of neurologic outcomes. The patient was followed up through personal examination and chart review from initial presentation to 6 months after the injury. Three months after cervical fusion and anticoagulation therapy, the patient was noted to have marked improvement of her visual acuity with almost complete return of strength, as well as normalization of vertebral vessel size. Because of the proximity of the vertebral artery to the atlantoaxial complex, it is susceptible to injury during trauma to the cervical spine. Injury to the vasculature supplying the brain may result in both immediate and delayed neurologic consequences.