title: Vertebral artery injury associated with a Jefferson fracture.
abstract: BACKGROUND
  The evaluation and treatment of Jefferson fractures, a burst fracture of the ring of Cl, has been well documented in the medical literature. Vertebral artery injury associated with a Jefferson fracture is very rare.
  
  
  METHODS
  The case study technique was used to summarize the case. Review of the literature was performed to discuss the case. Retrospective chart review of the 174 patients with cervical fractures admitted to St. Michael's Hospital from 1989-1994 was also performed.
  
  
  RESULTS
  The case of a patient with a Jefferson fracture, with bilateral lateral displacement of the lateral masses causing bilateral vertebral artery occlusions resulting in a lateral medullary and cerebellar infarction is reported. A review of the literature is provided.
  
  
  CONCLUSIONS
  A high index of suspicion for this injury is paramount, especially in patients with multiple trauma, where the diagnosis of Jefferson fractures can be delayed.
authors.affiliation: Division of Neurosurgery, St. Michael's Hospital, University of Toronto, Ontario, Canada.
authors.forename: G S
authors.initials: GS
authors.lastname: Walsh
authors.forename: M D
authors.initials: MD
authors.lastname: Cusimano
mesh_terms: D000328:Adult; D006801:Humans; D008297:Male; D016103:Spinal Fractures / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed; D014711:Vertebral Artery / Q000293:injuries*