Traumatic vertebral artery dissection

Case contributed by Derek Smith
Diagnosis almost certain


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

Patient Data

Age: 50 years
Gender: Female

CT angiography


Conventional arch anatomy. Incidental "kissing carotids" configuration.

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

Normal right vertebral artery.

Left C6 lateral mass fracture with cervical kyphosis.

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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