J Korean Neurosurg Soc.  2011 Dec;50(6):520-522. 10.3340/jkns.2011.50.6.520.

Emergent Endovascular Embolization for Iatrogenic Vertebral Artery Injury during Cervical Discectomy and Fusion

• Jung HJ
• Kim DM
• Kim SW
• Lee SM

• KMID: 2066903
• DOI: http://doi.org/10.3340/jkns.2011.50.6.520

Abstract

Injury to the vertebral artery during anterior cervical discectomy is rare but potentially fatal. We report a case of cerebellar infarction after endovascular embolization for iatrogenic vertebral artery injury at C5-C6 during an anterior cervical discectomy and fusion. A 61-year-old man had an intraoperative injury of the right vertebral artery that occurred during anterior cervical discectomy and fusion at C5-C6. Hemorrhage was not controlled successfully by packing with surgical hemostatic agents. While the patient was still intubated, an emergency angiogram was performed. The patient underwent endovascular occlusion of the right V2 segment with coils. After the procedure, his course was uneventful and he did not show any neurologic deficits. Brain computed tomographic scans taken 3 days after the operation revealed a right cerebellar infarction. Anti-coagulation medication was administered, and at 3-month follow-up examination, he had no neurologic sequelae in spite of the cerebellar infarction.

Keyword

Cervical discectomy; Vertebral artery injury; Endovascular occlusion; Cerebellar infarction

MeSH Terms

Brain
Diskectomy
Emergencies
Follow-Up Studies
Hemorrhage
Humans
Infarction
Middle Aged
Neurologic Manifestations
Vertebral Artery