Vertebral artery injuries following cervical spine trauma: a prospective observational study

Mueller, Christian A.; Peters, Inga; Podlogar, Martin; Kovács, Attila; Urbach, Horst; Schaller, Karl; Schramm, Johannes; Kral, Thomas

doi:10.1007/s00586-011-1887-2

Cited by 50 publications

(58 citation statements)

References 46 publications

(75 reference statements)

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“…17 This may explain the relatively lower rates of VAI in our study (13%) compared with other published series. 1,2,7 Our data may be consistent with the hypothesis that injuries which result in vertebral artery transection may in fact be protective for posterior circulation infarction, if the collateral circulation is sufficient to prevent an acute stroke, by preventing later embolic events at the time of recanalisation. However, further studies will be required to investigate this further.…”

Section: Discussionsupporting

confidence: 78%

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Posterior circulation infarction in patients with traumatic cervical spinal cord injury and its relationship to vertebral artery injury

et al. 2014

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Study design: Prospective study. Objective: To ascertain the prevalence of posterior circulation stroke in traumatic chronic spinal cord injured (SCI) patients and associated traumatic vertebral artery injuries (VAI). Methods: All adult patients with cervical SCI and American Spinal Injury Association Impairment Scale (AIS) grade A or B referred for follow-up magnetic resonance imaging of their spinal cord were invited to take part in the study between January 2010 and December 2012 at the National Spinal Injury Centre. Two additional sequences were added to the existing imaging protocol to evaluate the brain and vertebral arteries. Results: Ninety-eight patients were recruited. All imaging were analysed independently by three consultant radiologists. Posterior circulation infarcts were noted in seven (7%) patients. Significant VAI was noted in 13 patients (13%) with 10 occlusions and 3 with high-grade stenosis. However, only one patient had co-existent posterior circulation infarct and significant VAI. Conclusion: There is an increased prevalence of posterior circulation infarction in SCI patients. The relationship with associated traumatic VAI requires further investigation.

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Section: Discussionsupporting

confidence: 78%

“…[1][2][3] Rates of VAI associated with cervical spinal trauma vary significantly with the incidence ranging from 3 to 88% in the literature. Prospective studies suggest rates in the range of 17-27% 4-8 with a fatal outcome reported in rare cases.…”

Section: Introductionmentioning

confidence: 99%

Posterior circulation infarction in patients with traumatic cervical spinal cord injury and its relationship to vertebral artery injury

et al. 2014

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“…Structurally, it occurs on fixed segment and mobile segment junctions. The C6 transverse foramen is the most common and the C1/2 site is the second most common 11). It is com-mon in children with V2 segments and adults with V3 segments 4).…”

Section: Discussionmentioning

confidence: 99%

Delayed Infarction of Medullar and Cerebellum 3 Months after Vertebral Artery Injury with C1-2 Fracture: Case Report

Her

Kang

Abdullaev

et al. 2017

Korean J Neurotrauma

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The clinical manifestations of vertebral artery (VA) injury (VAI) after cervical trauma range from asymptomatic to fatal cerebral infarction. Thrombotic occlusion and embolization to the distal arteries can cause cerebellar and brain stem infarction within days after trauma. We report a 64-year-old man who underwent arthrodesis surgery for C1 and C2 fractures. He had left VAI at the C2 transverse foramen site but was asymptomatic. The patient experiences brainstem and cerebellar infarction 3 months after injury to the VA, and we are here to discuss the treatment of VAI after cervical trauma.

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“…Cothren et al 26 reported an overall CVA risk of 21% and advocated comprehensive screening, early diagnosis, and institution of early antithrombotic therapy for BCVI. 36 They documented no complications associated with either agent. 26 Mueller et al 36 treated 69 of 599 patients who sustained cervical spinal fracture and VAI.…”

Section: Jang Et Al 2011mentioning

confidence: 97%

Vertebral Artery Injuries and Blunt Cervical Trauma

Aguwa

Behr

et al. 2013

Contemporary Spine Surgery

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VOLUME 14 ■ NUMBER 5 ■ MAY 2013 the transverse foramen, typically at the C6 level. There, the artery ascends through the transverse foramen of the cervical vertebrae until the C1 level, where the artery exits the transverse foramen and winds posteromedially around the lateral mass and posterior arch of the atlas before piercing the dura of the spinal cord.The vertebral artery enters the base of the skull at the foramen magnum, joining its contralateral artery, forming the basilar artery and posterior circulation of the brain. Anterior branches from the vertebral artery are given off at the level of the foramen magnum to form the anterior spinal artery, supplying the majority of the spinal cord. Further vascularization to the spinal cord comes from the segmental arteries at the level of each cervical vertebra.Studies have shown that one vertebral artery usually predominates in circulationthe left in up to 75% of patients. Although the incidence of bilateral VAI in patients with blunt cervical spine trauma has been reported to be as high 25%, 19 compared with the right vertebral artery, unilateral left-sided injury is, in theory, associated with greater risk of neurologic compromise. Blunt traumatic VAI is most likely to occur while the artery courses through the transverse foramen. 4

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Vertebral artery injuries following cervical spine trauma: a prospective observational study

Cited by 50 publications

References 46 publications

Posterior circulation infarction in patients with traumatic cervical spinal cord injury and its relationship to vertebral artery injury

Posterior circulation infarction in patients with traumatic cervical spinal cord injury and its relationship to vertebral artery injury

Delayed Infarction of Medullar and Cerebellum 3 Months after Vertebral Artery Injury with C1-2 Fracture: Case Report

Vertebral Artery Injuries and Blunt Cervical Trauma

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