Sarkari Avijit, Singh Pankaj K, Mahapatra Ashok K
Department of Neurosurgery, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India.
Asian J Neurosurg. 2016 Jul-Sep;11(3):317. doi: 10.4103/1793-5482.144192.
The vertebral arteries are rarely injured in penetrating neck trauma due to their deep location in the foramen transversarium. These injuries in isolation are not associated with neurological deficits or ischemic changes on radiology as the collaterals are usually sufficient. We report a case of fatal unilateral vertebral artery stab injury leading to bilateral cerebellar and brainstem infarction. The carotid Doppler ruled out the presence of any carotid artery injury. Life-threatening injuries are possible in the presence of hypoplastic contralateral vertebral artery or inadequate flow from the anterior circulation not making up for the deficit. This emphasizes that thorough evaluation and timely management of suspected injuries to even a single vertebral artery should be undertaken.
由于椎动脉位于横突孔深处，在穿透性颈部创伤中很少受伤。孤立的这些损伤与神经功能缺损或影像学上的缺血改变无关，因为侧支循环通常足够。我们报告一例致命的单侧椎动脉刺伤导致双侧小脑和脑干梗死的病例。颈动脉多普勒检查排除了任何颈动脉损伤。在对侧椎动脉发育不全或前循环血流不足无法弥补缺损的情况下，可能会出现危及生命的损伤。这强调即使是对单一椎动脉的疑似损伤也应进行全面评估和及时处理。
