Jakanani George, Kenningham Richard, Bolia Aman
Department of Radiology, Leicester Royal Infirmary, Leicester, England.
J Emerg Med. 2012 Jul;43(1):e39-41. doi: 10.1016/j.jemermed.2009.08.005. Epub 2009 Sep 25.
Acute vascular injury is uncommon after cervical spine injury. We describe a recent case of active retropharyngeal bleeding from the thyrocervical artery after an acute cervical spine injury.
The case illustrates an unusual vascular injury diagnosed by 64-slice multidetector computed tomography (MDCT) and managed successfully by emergency transcatheter embolization.
A 65-year-old woman presented to the Emergency Department after a fall. MDCT scans of the cervical spine revealed a fracture of C5 and a large prevertebral hematoma. Subsequent MDCT carotid angiography revealed active bleeding from a branch of the right thyrocervical trunk. Superselective catheterization into the right thyrocervical trunk confirmed this as the source vessel. A 3-mm coil was deployed without complication.
This case illustrates an unusual arterial injury in the context of cervical spine trauma and how, as endovascular services become more accessible out of hours, the management of patients with acute arterial injury is increasingly a multidisciplinary team effort. Early recognition by the emergency physician of potential vascular injury and prompt referral for appropriate imaging will expedite treatment and improve clinical outcome.
颈椎损伤后急性血管损伤并不常见。我们描述了一例近期急性颈椎损伤后甲状腺颈干出现咽后活动性出血的病例。
该病例展示了通过64层多排螺旋计算机断层扫描（MDCT）诊断出的一种不寻常的血管损伤，并通过紧急经导管栓塞成功治疗。
一名65岁女性跌倒后被送往急诊科。颈椎的MDCT扫描显示C5骨折和巨大的椎体前血肿。随后的MDCT颈动脉血管造影显示右侧甲状腺颈干的一个分支有活动性出血。超选择性插管至右侧甲状腺颈干证实该血管为出血源血管。置入一枚3毫米的弹簧圈，未出现并发症。
该病例说明了颈椎创伤情况下一种不寻常的动脉损伤，以及随着非工作时间血管内治疗服务越来越容易获得，急性动脉损伤患者的治疗日益成为多学科团队的努力。急诊医生对潜在血管损伤的早期识别以及及时转诊进行适当的影像学检查将加快治疗并改善临床结局。
