BACKGROUND
Blunt vertebral artery injuries after cervical trauma due to the close anatomical relationship of the vertebral artery to the cervical spine may have fatal consequences because of posterior circulation ischemia and vertebrobasilar insufficiency. While the standard of care remains medical treatment by anticoagulation or antiplatelet therapy, surgical decompression of the vertebral artery is rarely indicated.
OBSERVATIONS
The authors present a case of selective decompression of a traumatically constricted vertebral artery within the transverse foramen of C2 presenting with vertebrobasilar insufficiency due to bilateral aplasia of the posterior communicating arteries and contralateral hypoplasia of the vertebral artery.
LESSONS
Because of their close relationship to the cervical spine, the vertebral arteries are at risk for blunt injury, which may present asymptomatically or with symptoms of posterior circulation ischemia or vertebrobasilar insufficiency either immediately or after a latency phase. The anatomical variability of (1) the vertebral arteries, (2) collateral brainstem perfusion, and (3) the individual injury pattern demands individualized treatment strategies. If endovascular treatment of hemodynamically relevant stenosis of the V2 segment of the vertebral artery poses too high a risk for vessel injury, decompression of the transverse foramen can be performed safely and without risk to the biomechanical stability of the cervical spine.
Die Diagnostik von Wirbelkörperfraktu-ren gehört zur Routine in der Radiologie. Dabei stellt sich bei nicht traumatischen Wirbelkörperfrakturen die Frage nach der Ursache. Häufig sind diese Frakturen das erste Symptom einer primären Osteoporose. Der hier vorgestellte Fall ist ein Beispiel dafür, dass sich hinter einer pathologischen Wirbelkörperfraktur auch eine seltene und komplexe Systemerkrankung wie die Mastozytose verbergen kann. Dies kann für den Patienten weitreichende Folgen haben.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.