Abstract
Study design:
Case report.
Objective:
To present and discuss the case of a patient who sustained a significant flexion compression injury of the cervical spine with resulting tetraplegia and development of cortical blindness.
Setting:
National Spinal Injuries Unit and Institute of Neurological Sciences, Southern General Hospital, Glasgow, Scotland, UK.
Methods:
Clinical and radiological follow-up of the patient.
Results:
Cortical blindness resulted from vertebral artery dissection associated with blunt cervical spine trauma. The patient is registered blind and is ventilator dependent.
Conclusion:
The potential complications of blunt vertebral artery injury remain poorly recognised. Screening is routinely not performed. Advances in noninvasive radiological techniques may result in recognition of asymptomatic disease and the potential for therapeutic intervention.
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References
Reid JD, Weigelt JA . Forty-three cases of vertebral artery trauma. J Trauma 1988; 28: 1007–1012.
Biffl WL et al. The devastating potential of blunt vertebral arterial injuries. Ann Surg 2000; 231: 672–681.
Nazir FS, Muir KW . Prolonged interval between vertebral artery dissection and ischemic stroke. Neurology 2004; 62: 1646–1647.
Cothren CC et al. Cervical spine fracture patterns predictive of blunt vertebral artery injury. J Trauma 2003; 55: 811–813.
Miller PR et al. Prospective screening for blunt cerebrovascular injuries: analysis of diagnostic modalities and outcomes. Ann Surg 2002; 236: 386–393.
Louw JA, Mafoyane NA, Small B, Neser CP . Occlusion of the vertebral artery in cervical spine dislocations. J Bone Joint Surg Br 1990; 72: 679–681.
Woodring JH, Lee C, Duncan V . Transverse process fractures of the cervical vertebrae: are they insignificant? J Trauma 1993; 34: 797–802.
Willis BK, Greiner F, Orrison WW, Benzel EC . The incidence of vertebral artery injury after midcervical spine fracture or subluxation. Neurosurgery 1994; 34: 435–441.
Chen CJ, Tseng YC, Lee TH, Hsu HL, See LC . Multisection CT angiography compared with catheter angiography in diagnosing vertebral artery dissection. AJNR Am J Neuroradiol 2004; 25: 769–774.
Clevert DA, Rupp N, Reiser M, Jung EM . Improved diagnosis of vascular dissection by ultrasound B-flow: a comparison with color-coded Doppler and power Doppler sonography. Eur Radiol 2005; 15: 342–347.
Bartels E, Flugel KA . Evaluation of extracranial vertebral artery dissection with duplex color-flow imaging. Stroke 1996; 27: 290–295.
de Bray JM, Penisson-Besnier I, Dubas F, Emile J . Extracranial and intracranial vertebrobasilar dissections: diagnosis and prognosis. J Neurol Neurosurg Psychiatry 1997; 63: 46–51.
Guidelines for the management of acute cervical spine and spinal cord injury (section on disorders of the spine and peripheral nerves of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons): management of vertebral artery injuries after nonpenetrating cervical trauma. Neurosurgery 2002; 50: S173–S178.
Miller PR et al. Blunt cerebrovascular injuries: diagnosis and treatment. J Trauma 2001; 51: 279–285.
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We acknowledge Dr C Santosh for his help with image selection and preparation.
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McCormick, M., Robinson, H., Bone, I. et al. Blunt cervical spine trauma as a cause of spinal cord injury and delayed cortical blindness. Spinal Cord 45, 687–689 (2007). https://doi.org/10.1038/sj.sc.3101995
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DOI: https://doi.org/10.1038/sj.sc.3101995
