Kobayashi Kazuyoshi, Imagama Shiro, Okura Toshiaki, Yoshihara Hisatake, Ito Zenya, Ando Kei, Ukai Junichi, Shinjo Ryuichi, Muramoto Akio, Matsumoto Tomohiro, Nakashima Hiroaki, Ishiguro Naoki
Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Department of Orthopaedic Surgery, Konan Kousei Hospital, Konan, Japan.
Nagoya J Med Sci. 2015 Aug;77(3):507-14.
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.
钝性脑血管损伤（BCVI）通常由颈部创伤引起，主要发生于高冲击力损伤。BCVI可能因椎动脉和颈动脉均受损而发生，若未得到恰当治疗及早期诊断，可能会致命。在此，我们描述一例52岁男性因下颈椎骨折合并直接钝性外力致颈动脉创伤而引发脑梗死的病例。最初，患者意识未受影响，但6小时后，因颈动脉创伤性夹层形成导致脑梗死，患者出现意识丧失。脑水肿极为严重，神经外科医生进行了急诊颅骨切除术和内减压术，但均无效果，患者于第7天死亡。这是一例由下颈椎骨折合并颈动脉创伤引发脑梗死的罕见病例。该病例提示，对于颈部钝性创伤患者，应考虑到颈部血管损伤的可能，并应进行额外的影像学检查。
