Departmental Bulletin Paper Fatal case of cervical blunt vascular injury with cervical vertebral fracture: a case report

Kobayashi, Kazuyoshi  ,  Imagama, Shiro  ,  Okura, Toshiaki  ,  Yoshihara, Hisatake  ,  Ito, Zenya  ,  Ando, Kei  ,  Ukai, Junichi  ,  Shinjo, Ryuichi  ,  Muramoto, Akio  ,  Matsumoto, Tomohiro  ,  Nakashima, Hiroaki  ,  Ishiguro, Naoki

77 ( 3 )  , pp.507 - 514 , 2015-08 , Nagoya University Graduate School of Medicine, School of Medicine
ISSN:0027-7622
Description
Blunt cerebrovascular injury (BCVI) is usually caused by neck trauma that predominantly occurs in high-impact injuries. BCVI may occur due to damage to both the vertebral and carotid arteries, and may be fatal in the absence of appropriate treatment and early diagnosis. Here, we describe a case of cerebral infarction caused by a combination of a lower cervical spinal fracture and traumatic injury to the carotid artery by a direct blunt external force in a 52-year-old man. Initially, there was no effect on consciousness, but 6 hours later loss of consciousness occurred due to traumatic dissection of the carotid artery that resulted in a cerebral infarction. Brain edema was so extensive that decompression by emergency craniectomy and internal decompression were performed by a neurosurgeon, but with no effect, and the patient died on day 7. This is a rare case of cerebral infarction caused by a combination of a lower cervical spinal fracture and traumatic injury to the carotid artery. The case suggests that cervical vascular injury should be considered in a patient with a blunt neck trauma and that additional imaging should be performed.
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