TRAUMATIC VERTEBRAL ARTERY-OCCLUSION IN AN AVIATOR - CASE-REPORT AND UPDATE ON DIAGNOSTIC TECHNOLOGIES

Traumatic vertebral artery Injuries are relatively rare, Until recentl y, insufficient neurodiagnostic technology and ct lack of normative da ta for the population of USAF aviators prevented recommending flying w aivers following such vascular injuries. We report the case of an avia tor who experienced a traumatic right vertebral artery occlusion with distal embolization. Timely access to a state of-the-art neurodiagnost ic evaluation, which included time of-flight magnetic resonance angiog raphy (MBA), and standard contrast angiography, provided anatomic imag ing at the time of injury and during the recuperative period, Sophisti cated neurologic testing protocols at the Armstrong Laboratory's Aerom edical Clinical Sciences Division, Brooks Air Force Base, TX, assessed in-depth this individual's functional status. Consult Service evaluat ors then compared his performance data with current data in the Head I njury Study in Aviators (HISA) data base. MRA, in comparison with stan dard contrast angiography, demonstrated anatomic stability of his vasc ular and neurologic lesions. He demonstrated a functional capacity con sistent with normal neurologic functioning in aviators which permitted recommending an occupational (flying) waiver. This case exemplified a pplication of sophisticated ACS neurologic testing protocols to aerome dical evaluations and the use of MRA technology as ct vascular screeni ng tool during medical followup.