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Vertebral Artery Injury in Blunt Neck Trauma

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Vertebral Artery Injury in Blunt Neck Trauma

  • Epidemiology
  1. Incidence may be as high as 22% of blunt neck injuries (70% when C-Spine Fracture is present)
  • Mechanism
  1. Vertebral Fracture (especially C1-C3)
  2. Neck rotation or distraction
  3. Neck hyperflexion or hyperextension
  4. Facet dislocation
  5. Foramen transversarium Trauma
  • 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
  • Differential Diagnosis
  • Imaging
  • Management
  1. Vascular Surgery Consultation if suspected vascular injury
  • References
  1. Kalsi, Kaufman and Hudson (2018) Crit Dec Emerg Med 32(10): 3-10