Temporary vertebral artery occlusion after C3 fracture dislocation injury and spontaneous resolution following reduction and instrumented fusion: case report and literature review

Yaeger, Kurt; Kellner, Christopher P.; Hickman, Zachary L.; Mocco, J; Margetis, Konstantinos

doi:10.1136/neurintsurg-2016-012671

Cited by 3 publications

(6 citation statements)

References 30 publications

(27 reference statements)

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“…It is usually caused by the overextension of the vertebral artery between the adjacent transverse foramina due to overflexion or overextension of the neck. 5,6) There is no consensus concerning which intervertebral segment is likely to cause complications by VAI, 3,6,11) but among our patients, no VAI was observed in two C6/7 cases, which may have been due to high mobility of the vertebral artery and high interferential action for shear stress at C6/7 compared with the other intervertebral segments. Although we were unable to find reports on the VAI complication rates of unilateral and bilateral dislocation in our patients, it was noted in two of four patients with unilateral dislocation, suggesting an influence of torsion of the vertebral artery.…”

Section: Discussionmentioning

confidence: 63%

“…Regarding the pathology of VAI, many studies have reported that the essential condition is arterial wall injury by the fracture fragment and dissection accompanying arterial wall extension. 5 , 6 , 13) The neurological outcome is aggravated by cerebral embolism due to thrombus formation in the injured tunica intima during the course of injury, or hemodynamic cerebral ischemia accompanying stenosis or occlusion of the region caused by mural thrombus. 3 , 13) In addition, vascular rupture-induced false aneurysms and arteriovenous fistulas have been reported.…”

Section: Discussionmentioning

confidence: 99%

“… 4 , 5) On the contrary, cervical spine fracture is noted in 70% or more VAI cases. 6) VAI complication rate with facet dislocation, subluxation, and fracture of the transverse foramen were reported in 80%, 75%, and 46% of cases, respectively. 1 , 3 , 7 – 9) However, for treatment, reports of course observation, antithrombotic drug administration, and parent artery occlusion (PAO) of the affected vertebral artery are mixed with no consensus, as the pathology and complicating injury differ among patients.…”

Section: Introductionmentioning

confidence: 97%

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Evaluation for Vertebral Artery Injury with Cervical Dislocated Fracture and Optimal Treatment before Reduction

Suga

Mitome-Mishima

Yoshida

et al. 2022

JNET

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Objective: Cervical dislocated fractures frequently cause vertebral artery injury (VAI), which, in turn, propagates the thrombus at the site of injury. Cerebral embolism due to a thrombus after the reduction of dislocation leads to a poorer neurological outcome. Therefore, we investigated the outcome of treatment for cervical dislocated fractures and the usefulness of parent artery occlusion (PAO) before reduction.Methods: Eight patients with cervical dislocated fractures with a locked facets treated at our hospital between January 2018 and December 2020 were evaluated. We retrospectively examined patient characteristics and clinical outcomes.Results: Among the eight patients, two were injured at C4/5, four at C5/6, and two at C6/7. All patients had locked facets.Four patients had bilateral dislocation, while the others had unilateral dislocation. Two patients with unilateral dislocation had ipsilateral vertebral artery occlusion (VAO), while the other six did not. Both patients with VAO underwent PAO to prevent cerebral embolism before reduction. The six patients who did not have VAI underwent reduction without preprocedural treatment. No cerebral ischemic complications were observed. One patient died due to paralysis of the respiratory muscles caused by spinal cord injury but the remaining seven recovered well. Conclusion:PAO before reduction for cervical dislocated fractures with VAO may be effective in preventing cerebral embolism after reduction.

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Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

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Evaluation for Vertebral Artery Injury with Cervical Dislocated Fracture and Optimal Treatment before Reduction

Suga

Mitome-Mishima

Yoshida

et al. 2022

JNET

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“…Although this type of lesion is rare, dislocation lesions of the cervical spine in hyperflexion and rotation have been described (36). Further reports additionally indicated the occurrence of similar unusual isolated non-C1/C2 vertebral bone fractures with dorsal translocation (37) or C3-fracture dislocation that even have been survived (38). In summary, we speculate that, while the man was stunned by a blow to the skull, the disruption of the cervical spinal cord occurred by a massive blow.…”

Section: Pre-and Perimortem Traumatamentioning

confidence: 97%

Trauma of bone and soft tissues in South American mummies—New cases provide further insight into violence and lethal outcome

Begerock¹,

Loynes²,

Peschel³

et al. 2022

Front. Med.

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There exist numerous reports on violence in South American populations which shed a particular light on life and living conditions in those historic communities. Most studies have been performed on collections of isolated skulls. Whole-body investigations especially on well-preserved mummified human remains are rare. In the present study we investigated three South American mummies predating the Colonial Spanish period. The “Marburg” man lived between 996 and 1147 CE and was buried in typical burial bundle. The analysis of the textiles, ceramics and fishing tools associated with his naturally mummified body suggests that he most likely originated from the Arica region in Northern Chile and was possibly part of a fishing community. The “Delémont” natural mummies belong to an adult male and an adult female, respectively. The mummies, the textiles and grave goods were investigated. The ceramics suggest a provenance from the Arequipa region, supposing that all the artifacts were originally associated with the two mummies. The Delémont male mummy is 14C dated between 902 and 994 CE and the “Delémont” female mummy 14C dated between 1224 and 1282 CE. All mummies underwent Multidetector Computed Tomography which showed evidence of trauma, some of which were interpreted as evidence of interpersonal violence. An interdisciplinary approach was applied with the particular intention to identify trauma sequels and to evaluate their paleo-forensic potential. Evidence of violence was identified in the two male individuals. Our study provides evidence that the interdisciplinary investigation of well-preserved human remains may detect much more frequent traces of intentional trauma than previously thought. Particularly, trauma against the body may not be identified in studies on skulls alone, and trauma residues of internal organs/soft tissues will only be seen in mummies. We therefore add further evidence of two cases of (lethal) trauma in pre-colonial South-American male individuals.

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“…Many authors studied VAD, but most of them are either single case reports[ 10 11 12 13 14 15 16 17 ] or case series,[ 18 19 20 21 ] and very few studies tried to describe the traumatic cervical vertebral pathology in detail.…”

Section: Introductionmentioning

confidence: 99%

Vertebral artery dissection in acute cervical spine trauma

Gupta

Siroya

Bhat

et al. 2022

J Craniovert Jun Spine

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Objective: The aim of this study was to study mechanism, risk factors, and prognosis of patients with vertebral artery dissection (VAD) from acute cervical spine trauma (CST). Methods: A total of 149 consecutive patients were chosen from 2014 to 2019 from our institute data base, and their records were retrospectively studied. Morphology of fracture and subluxation were studied in detail with respect to the presence or absence of VAD. Results: Patients were divided in subsets of axial spine injury and subaxial spine injury. Subgroup and group analysis was performed and computerized tomography angiogram, MR angiogram and T1/T2 axial scans were studied to identify VAD, an incidence of 14.1% was found. Patients having infarcts in posterior circulation were also identified. Conclusion: There is a significant contribution of biomechanics of CST and evolution of VAD. This is an important consideration to prevent significant morbidity and mortality. Hence, a diagnostic algorithm which can be applied in any hospital setup is the need of the hour.

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Temporary vertebral artery occlusion after C3 fracture dislocation injury and spontaneous resolution following reduction and instrumented fusion: case report and literature review

Cited by 3 publications

References 30 publications

Evaluation for Vertebral Artery Injury with Cervical Dislocated Fracture and Optimal Treatment before Reduction

Evaluation for Vertebral Artery Injury with Cervical Dislocated Fracture and Optimal Treatment before Reduction

Trauma of bone and soft tissues in South American mummies—New cases provide further insight into violence and lethal outcome

Vertebral artery dissection in acute cervical spine trauma

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