VERTEBROBASILAR THROMBOSIS ASSOCIATED WITH NONPENETRATING CERVICAL-SPINE TRAUMA

Vertebral artery injuries associated with blunt trauma to the cervical spine are rare. Five cases of vertebrobasilar complications after blu nt trauma to the cervical spine are reported. Four were involved in mo tor vehicle accidents, and one suffered a diving injury. All of these patients had documented cervical spine fractures. For two patients, th e diagnosis of vertebral artery thrombosis was made on the basis of ma gnetic resonance angiography (MRA), and for the remaining three, cervi cal four-vessel arteriograms (CFVAs), were used. All the patients had occlusion of now in either the vertebral artery or in the vertebrobasi lar circulation. The patients presented with acute, non-specific chang es in neurological status. Two patients had infarctions in the vertebr obasilar tertiary, one had an infarction in the middle cerebral artery territory, and two did net show evidence of cerebral infarction. Thre e of the patients were treated with anticoagulants. Of these, two show ed a stabilization of their neurological status, and one died. The fou r surviving patients improved with early physical and occupational the rapy. Although CFVA remains the ''gold standard'' for diagnosing these injuries, newer modalities, such as MRA, may be useful adjuncts. Earl y stabilization of the cervical spine injury and anticoagulation are b eneficial.