Emergency Medicine Book

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Vertebral Artery Injury in Blunt Neck Trauma

Aka: Vertebral Artery Injury in Blunt Neck Trauma
  1. See Also
    1. Vertebral Artery Dissection
    2. Cervical Artery Dissection
    3. Carotid Artery Injury in Blunt Neck Trauma
  2. Epidemiology
    1. Incidence may be as high as 22% of blunt neck injuries (70% when C-Spine Fracture is present)
  3. Risk Factors
    1. Head Trauma
    2. Cervical Spine Trauma
    3. Blunt Neck Trauma
  4. Mechanism
    1. Vertebral Fracture (especially C1-C3)
    2. Neck rotation or distraction
    3. Neck hyperflexion or hyperextension
    4. Facet dislocation
    5. Foramen transversarium Trauma
  5. Symptoms
    1. Asymptomatic initially in many cases (despite occult life threatening injury)
    2. Posterior Circulation symptoms
      1. Dysarthria
      2. Ataxia or impaired balance or coordination
      3. Visual Field defect
      4. Horner Syndrome
      5. Altered Level of Consciousness
  6. Differential Diagnosis
    1. See Carotid Artery Injury in Blunt Neck Trauma
  7. Imaging
    1. CT Angiogram Neck Indications
      1. See Denver Screening Criteria for Blunt Cerebrovascular Injury
  8. Management
    1. Vascular Surgery Consultation if suspected vascular injury
  9. References
    1. Kalsi, Kaufman and Hudson (2018) Crit Dec Emerg Med 32(10): 3-10

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