Department of Neurosurgery, University of Health Sciences Bozyaka Training and Research Hospital, İzmir-Turkey.
Ulus Travma Acil Cerrahi Derg. 2021 Nov;27(6):697-701. doi: 10.14744/tjtes.2020.63679.
Bilateral vertebral artery occlusion is an uncommon and mortal injury that could be seen after high-energy traumas. We illustrate an extreme case of bilateral vertebral artery occlusion following traumatic cervical disruption with complete spinal cord injury in a patient with ankylosing spondylitis. A 49-year-old male was admitted to our emergency department after a motor vehicle accident. The American Spinal Injury Association Impairment Scale was a complete A grade. Computed tomography (CT) scan of the cervical region revealed complete disruption between C2 and C3 levels. Magnetic resonance imaging showed apparent compression and narrow calibration of the spinal cord. CT angiography demonstrated occlusion of the bilateral vertebral arteries. Because of the neurological status of the patient, extensive hematoma, and edema at the region, no surgical intervention could be planned. The patient died on the second day of his hospitalization. Only fourteen cases of bilateral vertebral artery occlusion following blunt cervical spine traumas have been reported to date. They have a possibility to cause vertebrobasilar ischemic events with a poor prognosis of morbidity and mortality. The gold standard of diagnosis is the catheter angiography, but also CT angiography has close sensitivity and specificity. The treatment strategies of vertebral artery occlusion are still unclear.
双侧椎动脉闭塞是一种罕见且致命的损伤，可发生于高能创伤后。我们展示了一例强直性脊柱炎患者在创伤性颈椎断裂伴完全性脊髓损伤后出现双侧椎动脉闭塞的极端病例。一名 49 岁男性在一场机动车事故后被收入我院急诊。美国脊髓损伤协会损伤分级为完全 A 级。颈椎区 CT 扫描显示 C2 至 C3 水平完全断裂。磁共振成像显示脊髓明显受压和狭窄。CT 血管造影显示双侧椎动脉闭塞。由于患者的神经状况、该区域的广泛血肿和水肿，无法计划手术干预。患者在住院第二天死亡。迄今为止，仅有 14 例钝性颈椎创伤后出现双侧椎动脉闭塞的病例报告。它们有可能导致椎基底动脉缺血事件，预后不良，病死率和病残率高。诊断的金标准是导管血管造影，但 CT 血管造影也具有较高的灵敏度和特异性。椎动脉闭塞的治疗策略仍不明确。
