Korean J Neurotrauma.  2017 Apr;13(1):29-33. 10.13004/kjnt.2017.13.1.29.

Delayed Infarction of Medullar and Cerebellum 3 Months after Vertebral Artery Injury with C1-2 Fracture: Case Report

• Her Y
• Kang SH
• Abdullaev
• Kim N

• KMID: 2378247
• DOI: http://doi.org/10.13004/kjnt.2017.13.1.29

Abstract

The clinical manifestations of vertebral artery (VA) injury (VAI) after cervical trauma range from asymptomatic to fatal cerebral infarction. Thrombotic occlusion and embolization to the distal arteries can cause cerebellar and brain stem infarction within days after trauma. We report a 64-year-old man who underwent arthrodesis surgery for C1 and C2 fractures. He had left VAI at the C2 transverse foramen site but was asymptomatic. The patient experiences brainstem and cerebellar infarction 3 months after injury to the VA, and we are here to discuss the treatment of VAI after cervical trauma.

Keyword

Vertebral artery; Cervical spine; Trauma; Ischemia; Clinical presentation

MeSH Terms

Arteries
Arthrodesis
Brain Stem
Brain Stem Infarctions
Cerebellum*
Cerebral Infarction
Humans
Infarction*
Ischemia
Middle Aged
Vertebral Artery*

Figure

• 

  FIGURE 1 Computed tomography show fracture of C1 and C2. (A) Axial view show fracture lines (arrow) at anterior and posterior arch of atlas. (B) Sagittal reconstruction show displacement and angulation of odontoid process (arrow).

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  FIGURE 2 Three dimension reconstruction of vertebral artery computed tomography angiography show occlusion (arrow) at the C2 transverse process level.

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  FIGURE 3 Postoperative cervical lateral X-ray showed occipital-C1 lateral mass-C2 pedicle-C3 pedicle screw fixation and posterior on-lay bone graft.

• 

  FIGURE 4 Diffusion magnetic resonance imaging show restriction (arrow) at the level of medullar (A) and cerebellar (B).

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