CARDIAC-ARREST AFTER TRAFFIC ACCIDENT INDUCED THROUGH VAGAL REFLEX INA CASE WITH BILATERAL STENOSIS OF VERTEBRAL ARTERIES

An 84-year-old driver suffered cardiac arrest after a traffic accident . He was quickly resuscitated and transferred to a hospital where he w as treated in a state of unconsciousness and respiratory failure for 2 0 days until his death. The brain stem was rendered anoxic during card iac arrest, which caused the respiratory failure, Artificial ventilati on and catecholamine infusion were carried out, resulting in myocardia l degeneration, Bilateral stenosis of the vertebral arteries was discl osed, but no injuries or hemorrhage of the brain and spinal cord were detected. On days 3 and 4 after admission, immediately after the head of the victim was flexed forward for examinations, cardiac arrest was induced twice, but was controlled either by administering atropine or by restoring the original posture. Positional change is known to induc e vagal reflex that results in bradycardia, hypotension or cardiac arr est in sensitive persons. The victim might have undergone the reflex-m ediated cardiac arrest after the accident, to which the stenosis of th e vertebral arteries may have contributed.