頚椎外傷に伴った椎骨動脈損傷の 3 例

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Vertebral arteries appear to be susceptible to injury at the time of cervical spine trauma because of their close anatomical relationship to the spine. However, ischemic symptoms rarely occur after cervical spine injury. The authors report three cases of vertebral artery dissection associated with cervical spine trauma. Case 1 is a 10-year-old boy who was hospitalized with cerebellar infarction following neck trauma. He had atlanto-axial dislocation and cerebral angiography revealed dissection of the left vertebral artery at the third segment. The patient underwent atlanto-axial arthrodesis and was discharged without any neurological deficits. Case 2 is a 53-year-old man with atlanto-axial rotatory fixation. He was suffering from neck pain and torticollis after injury. Although his right vertebral artery was occluded at the C5/6 segment, he didn't show any ischemic brain symptoms. Case 3 is a 49-year-old man with a past history of cervical spine trauma. He developed recurrent vertebrobasilar TIA. He had an unstable cervical spine at C4/5 and his left vertebral artery was occluded at C4/5 segment. His TIA disappeared after immobilization with neck collar. After anterior cervical discectomy with iliac bone fusion for C4/5, the patient was discharged without any unfavorable symptoms. Since vertebral artery dissection is not rare in cervical spine fracture or dislocation, vertebral angiography should be indicated for those who have ischemic brain symptoms after cervical traumas. Individualized management is needed to vertebral artery dissection with cervical spine fracture or dislocation.
日本脊髄外科学会の論文
1997-12-15

頚椎外傷に伴った椎骨動脈損傷の 3 例

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