Progress in research on vertebral artery injury resulting from blunt cervical spine trauma
- VernacularTitle:颈椎闭合性创伤继发椎动脉损伤的研究进展
- Author:
Chao LI
;
Bin NI
- Publication Type:Journal Article
- Keywords:
Cervical fracture;
Vertebral artery;
Vascular injury;
Magne tic resonance angiography
- From:
Chinese Journal of Orthopaedic Trauma
2002;0(04):-
- CountryChina
- Language:Chinese
-
Abstract:
Articles about vertebral artery injuries secondary to blunt cervical spine trauma are increasing recently. The incidence of the disorder is reported from 19.4% to 46% in the literature. It has been found that unilate ral facet dislocations and bone fragments in the foraminal canal (comminuted fr acture of the foramen transversarium) have a significant association with the vertebral artery injuries,and that rotational violence may be a significant fac tor in causing vertebral artery occlusion. Patients with vertebral artery injuri es may have such symptoms as blurry vision, syncope, dysphagia and Wallenbergs syndrome. MRA(magnetic resonance angiography) is noninvasive and easy to per form at the time of initial MR. A routine evaluation of the extracranial circula tion with MRA should be performed as an additional sequence to all initial MR of the cervical spinal cord injury. Conventional angiography may be indicated only if the patient develops symptoms of cerebral ischemia. The benefit of antithrom botic therapy in reducing neurological morbidity and improving outcome has not y et been established and needs long-term follow-up. Operative management should be reserved only for patients with severe active bleeding or when interventiona l radiology fails. The surgical exposure is complex and demands excellent knowle dge of the local anatomy.
