MANAGEMENT OPTIONS IN VERTEBRAL ARTERY INJURIES

The treatment of 22 patients with vertebral artery injuries was review ed. Only four patients required an emergency operation. zMost of the i njuries (13 of 22) were successfully managed by observation. Five pati ents were managed by angiographic embolization which was successful in three. In three patients with an aneurysm and arteriovenous fistula, proximal embolization of the vascular lesion was not adequate and a su boccipital craniectomy was required for distal ligations. Most vertebr al artery injuries can safely be managed without an operation, or by a ngiographic embolization. Surgical intervention should be reserved for patients with severe bleeding or where embolization has failed.