Basilar artery occlusion due to vertebral artery injury treated with thrombectomy and distal vertebral artery embolization through the unaffected side.

Autor: Tanimura M; Department of Neurosurgery, Kurashiki Central Hospital, Kurashiki, Japan., Ikeda H; Department of Neurosurgery, Kurashiki Central Hospital, Kurashiki, Japan., Fujiwara T; Department of Neurosurgery, Kurashiki Central Hospital, Kurashiki, Japan., Uezato M; Department of Neurosurgery, Kurashiki Central Hospital, Kurashiki, Japan., Osuki T; Department of Neurosurgery, Kurashiki Central Hospital, Kurashiki, Japan., Kinosada M; Department of Neurosurgery, Kurashiki Central Hospital, Kurashiki, Japan., Kurosaki Y; Department of Neurosurgery, Kurashiki Central Hospital, Kurashiki, Japan., Chin M; Department of Neurosurgery, Kurashiki Central Hospital, Kurashiki, Japan.
Jazyk: angličtina
Zdroj: Surgical neurology international [Surg Neurol Int] 2024 Jan 12; Vol. 15, pp. 12. Date of Electronic Publication: 2024 Jan 12 (Print Publication: 2024).
DOI: 10.25259/SNI_948_2023
Abstrakt: Background: There is no established opinion regarding embolization of asymptomatic traumatic vertebral artery injuries that do not require cervical spine repair and fixation.
Case Description: A 78-year-old man fell backward from a height of about 1 m and was rushed to his previous hospital. He had a fracture of the left transverse process of the 6 th cervical vertebra. Six hours after the trauma, he became unconscious; magnetic resonance angiography showed occlusion of the left vertebral and basilar arteries, and he was transferred to our hospital. The basilar artery was completely recanalized 430 min after the onset of unconsciousness. Due to the presence of thrombi in the distal vertebral artery at the level of the 6 th cervical vertebra and collateral blood flow from the deep cervical artery, the distal vertebral artery was occluded to prevent embolism. Postoperative diffusion-weighted imaging showed extensive infarction in the posterior circulation, and the patient died two days after surgery.
Conclusion: In the case of vertebral artery injury, preparation for early occlusion of the basilar artery is necessary. If a thrombus and collateral blood flow are present distal to the vertebral artery injury, distal vertebral artery embolization may be necessary to prevent embolism.
Competing Interests: There are no conflicts of interest.
(Copyright: © 2024 Surgical Neurology International.)
Databáze: MEDLINE