Cervical Spine Injury Assosiated with Vertebral Artery Dissection

Mohammad Samadian, Seyed Ali Mousavinejad


Background: Although the vertebral artery injuries (VAI) associated with cervical spine trauma are usually clinically occult, they may cause fatal ischemic damage to the brain stem and cerebellum.

Case presentation: The patient is a 76 years old man that reffered to our hospital with falling tree (about 5 meter). On arrival at the Emergency Department the patients vital signs were all within normal physiological parameters. GCS was 15/15. He had suffered from neck pain and headache and vertigo. In physical examination he had upper cervical spine tenderness but there was no abnormal palpable deformity. Other physical examination was normal. Brain CT scan was normal.in cervical spine x-ray there was no abnormality.The patient was underwent to cervical spine ct scan C-spine CT demonstrated posrterior arch of atlas extended to foramen transversariom and transvers process. CT-angio demonstrated right vertebral artery dissection. The patient was underwent to treat by UFW heparin and warfarin.

Conclusion: Blunt vertebral arterial injuries are more common than previously reported. Screening patients based on injury mechanisms and patterns will diagnose asymptomatic injuries, allowing the institution of therapy before stroke. Systemic anticoagulation appears to be effective therapy.  


Cervical spine; CT angiography; Vertebral artery