Vertebral artery trauma: acute recognition and treatment
D. E. Meier, B. E. Brink and W. J. Fry
Vertebral artery injury is uncommon and may be initially unrecognized.
Sequelae of vertebral artery injury include arteriovenous fistulae and
pseudoaneurysms that may appear months after injury. The incidence of the
sequelae is unknown. Cervical angiography used in the routine evaluation of
a patient with penetrating neck trauma readily demonstrates vertebral
artery injuries. This series of 13 cases demonstrates the low morbidity
associated with the treatment of isolated vertebral artery injuries. A
technique for proximal and distal ligation of the vertebral artery is
presented. Its use is recommended in the treatment of any patient with
vertebral artery injury who has a normal contralateral vertebral artery and
no demonstrable extracranial branches from the vertebral artery to the
spinal cord.
