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一例罕见的屈曲泪滴型颈椎骨折合并钝性椎动脉损伤致中风病例报告

A Rare Case Report of Flexion Teardrop Cervical Fracture with Blunt Vertebral Artery Injury Leading to Stroke.

作者信息

Srivastava Sudhir, Raj Aditya, Bhosale Sunil, Marathe Nandan, Gaddikeri Manojkumar

机构信息

Department of Orthopedics, Seth GS Medical College and King Edward Memorial Hospital, Mumbai, Maharashtra, India.

出版信息

Asian J Neurosurg. 2021 Feb 23;16(1):187-190. doi: 10.4103/ajns.AJNS_31_20. eCollection 2021 Jan-Mar.

Abstract

Non penetrating trauma to vertebral artery is a known complication in craniovertebral trauma. They are mainly reported with facet dislocations or injuries involving the foramen transversarium. Such a type of injury is rarely seen with flexion injuries. We report such a case leading to cerebellar stroke in a young male presenting to us with hemiparesis. A 43-year-old male presented to us 1 month post trauma after a motor vehicular accident with complaint of weakness of right half of the body since the trauma. He suffered blunt trauma to head and neck and complained of a flail right upper limb since trauma and weakness of the right lower limb which had partly improved. He was conservatively managed elsewhere. Radiographic investigations revealed complete occlusion of the right vertebral injury above the level of 6 cervical vertebra and flexion teardrop fracture of 5 cervical vertebra. He was managed conservatively for the vertebral artery injury (VAI) and corpectomy of C5 vertebra with anterior cervical plating and fusion. Such a rare type of injury can present with unexplained neurodeficit which needs appropriate radiological investigations for diagnosis before ascribing the cause to cord trauma. Hence, all high velocity motor vehicular accidents with associated fractures and neurodeficit should be screened for blunt VAIs.

摘要

椎动脉非穿透性创伤是颅颈创伤中一种已知的并发症。它们主要与小关节脱位或涉及横突孔的损伤有关。这种类型的损伤在屈曲性损伤中很少见。我们报告了一例年轻男性因偏瘫前来就诊,最终导致小脑卒中的病例。一名43岁男性在机动车事故创伤1个月后前来就诊,自创伤后一直主诉身体右侧无力。他头部和颈部遭受钝性创伤,自创伤后一直主诉右上肢连枷样摆动以及右下肢无力,不过右下肢无力症状有所改善。他在其他地方接受了保守治疗。影像学检查显示,右侧椎动脉在第6颈椎水平以上完全闭塞,第5颈椎屈曲泪滴样骨折。他因椎动脉损伤(VAI)接受了保守治疗,并对第5颈椎进行了椎体次全切除,同时进行了前路颈椎钢板固定和融合术。这种罕见类型的损伤可能表现为无法解释的神经功能缺损,在将病因归因于脊髓损伤之前,需要进行适当的影像学检查以明确诊断。因此,对于所有伴有骨折和神经功能缺损的高速机动车事故,都应筛查是否存在钝性椎动脉损伤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/616b/8202375/6d8a1de3214c/AJNS-16-187-g001.jpg

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