[Traumatic rupture of the vertebral artery associated with fracture of the cervical spine: a case report].
We report here a case of traumatic rupture of the vertebral artery associated with fracture of the cervical spine. A 72-year-old woman was found at the bottom of the stairs by her family. She was immediately transferred to our hospital. She was, in spite of being in a state of shock, alert and oriented with normal respiration. A curvilinear laceration at the right suboccipital region was noticed. On neurological examination, she was diagnosed as having tetraparesis. Roentgenograms confirmed fractures of a vertebral body at C 6 and a transverse process at C 7. Head CT scan demonstrated a small low density area in the left putaminal region with cortical atrophy. As subcutaneous swelling of the left lower cervical portion was gradually taking place, vertebral arteriography was performed. Through left vertebral arteriography, extravasation of the contrast medium was demonstrated at the C6-7 level. Eighteen hours after admission, direct operation on the torn vessel was carried out through a supraclavicular linear skin incision. On operation, there was active bleeding from the lacerated vertebral artery at its point of entrance into the foramen transversarium. The bleeding point of the vertebral artery was trapped at the C 6 level. Postoperatively, the symptoms of the tetraparesis were improving. Two days after the operation, she had some food by herself. Suddenly, she had cardiac arrest five days after admission, and soon expired. It was 13 days since she had been admitted. Traumatic tear of a vertebral artery is very rare. Fourteen cases of intra-and extracranial vertebral artery rupture in closed head injury have been reported in previous writings.(ABSTRACT TRUNCATED AT 250 WORDS)
Okuyama
T
T
Department of Neurosurgery, Hakodate Municipal Hospital, Japan.
Niwa
J
J
Shimizu
K
K
Hirai
H
H
Kubota
T
T
D000058:Accidental Falls; D000059:Accidents; D000368:Aged; D002574:Cervical Vertebrae / Q000293:injuries*; D050723:Fractures, Bone / Q000150:complications*; D006801:Humans; D008297:Male; D009104:Multiple Trauma / Q000209:etiology*; D012421:Rupture; D014711:Vertebral Artery / Q000293:injuries*