DELAYED SEQUELAE OF VERTEBRAL ARTERY DISSECTION AND OCCULT CERVICAL FRACTURES

We report three patients who developed delayed (ie, more than a week a fter the injury) symptoms of vertebrobasilar ischemia following motor vehicle accidents. The patients all had angiographic evidence of verte bral artery dissection and, upon further evaluation, occult fractures of the second cervical vertebra that were not detected by simple cervi cal spine radiography and required polytomography or CT for diagnosis. Vertebral artery dissection can result from occult cervical spine fra ctures and may present with delayed symptoms of brain ischemia.