Traumatic rupture of the basilar artery - Report of two cases and review of the literature

Two cases of traumatic rupture of the basilar artery are reported. In the f irst case, severe basal subarachnoid hemorrhage (SAH) due to a complete tra nsverse tear of the basilar artery was observed in a 53-year-old restrained male driver who was involved in a head-on collision while intoxicated and drowsy. He lost consciousness shortly after the accident and was admitted t o hospital in cardiopulmonary arrest. Intensive resuscitative therapies pro duced cardiac response, but he died 50 minutes after the accident. The etha nol concentration in his blood and urine was 0.35 and 0.55 mg/ml, respectiv ely. In the second case, SAH due to a similar tear of the basilar artery wa s observed in a 47-year-old man who received several fist blows to the face while intoxicated. He suddenly lost consciousness after the final blow and was admitted to hospital in cardiopulmonary arrest. Intensive resuscitativ e therapies produced cardiac response, but he died 6 hours after the event. In these cases, the mechanism of the traumatic rupture of the basilar arte ry is thought to be overstretching due to hyperextension of the head, and i ntoxication, drowsiness, or both may have interfered with the decedents' ab ility to protect themselves; thus, the hyperextension of the head may have been rather forceful.