Traumatic vertebral artery dissection

Case contributed by Dr Derek Smith

Presentation

Medium speed RTC. Known cervical fracture, managed appropriately. Ongoing left hand parasthesia.

Patient Data

Age: 50 years
Gender: Female
CT

CT angiography

Conventional arch anatomy. Incidental "kissing carotid" configuration.

Left vertebral artery dissection with threadlike vessel and multiple foci of disrupted flow. No extrinsic compression or hematoma.

Normal right vertebral.

Left C6 lateral mass fracture with cervical kyphosis.

CT

Key images

Key images with C6 left lateral mass fracture, left vertebral artery dissection and incidental "kissing carotids".

Case Discussion

This is a good example of complications that can follow from cervical spine injury.

There is foraminal compromise due to the facet joint and disc disruption which accounts for her symptomatology.

Left vertebral artery dissection is demonstrated. These can follow spinal injury, but can also occur after minor injury or manipulation. Management is usually conservative.

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Case information

rID: 57166
Published: 10th Dec 2017
Last edited: 16th Jul 2018
Inclusion in quiz mode: Included

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