DELAYED SYMPTOMS AND DEATH AFTER MINOR HEAD TRAUMA WITH OCCULT VERTEBRAL ARTERY INJURY

Head injury without loss of consciousness is seldom accompanied by gra ve complications. We report the case of an 18 year old cyclist who was struck by a car in a minor road traffic accident, suffered minor head injury without loss of consciousness, and died unexpectedly seven wee ks later with vomiting and coma. Necropsy revealed an expanding cerebe llar infarct and vertebral artery thrombosis, superimposed on an old d issecting intramural haematoma of the right vertebral artery in the at lantoaxial region. Vertebrobasilar occlusion after minor head trauma, hyperextending or rotating neck injury, or neck manipulation is common est in young people. Occult ligamentous injury to the cervical spine a fter trauma may be a contributing factor to the pathogenesis of verteb ral artery damage after injury to the neck.