Global Spine J 2014; 04(03): 187-190
DOI: 10.1055/s-0034-1366972
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Traumatic Dissection of Four Brain-Supplying Arteries without Neurologic Deficit

Florian Pröscholdt1, Sandro Heining1, Maciej Powerski2, Christian H. Nolte3, Wolfgang Ertel1
  • 1Department of Special Orthopaedic, Trauma and Reconstructive Surgery, Charité–University Medicine Berlin, Berlin, Germany
  • 2Department of Radiology, Charité–University Medicine Berlin, Berlin, Germany
  • 3Department of Neurology, Center for Stroke Research, Charité–University Medicine Berlin, Berlin, Germany
Further Information

Publication History

18 June 2013

17 December 2013

Publication Date:
31 January 2014 (eFirst)

Abstract

Study Design Case report and review of the literature.

Objectives Case report of a traumatic dissection of all major brain-supplying arteries resulting from a horseback-riding accident. Overview of the literature on diagnostic and therapeutic recommendations.

Methods Case presentation. For the discussion, handpicked articles and PubMed database research with the keywords “dissection,” “vertebral artery,” “spine trauma,” “computed tomography,” “magnetic resonance imaging,” and “angiography” were used.

Results Despite high-energy induced acute lesion of all four cervical arteries, this 45-year-old patient did not demonstrate signs of microemboli nor suffer from stroke.

Conclusion In case of high-energy trauma of the head and/or the neck, emergency physicians must consider traumatic cervical artery dissection (TCAD). Thus, emergency care algorithms should routinely include computed tomography angiography and magnetic resonance imaging. Although the incidence of TCAD-induced stroke is low, antiplatelet therapy is recommended in the presence of TCAD.