Vertebral Artery Injury in the Cervical Spine

• DOI: 10.2106/jbjs.rvw.20.00118
• Publication Date: 2021-01-19T20:00:05Z
• Authors: Pradip Ramamurti; Jeffrey Weinreb; Safa C. Fassihi; Raj Rao; Shalin Patel
• Keywords: Pseudoaneurysm; Blunt trauma; Computed Tomography Angiography

Although rare, injury to the vertebral artery (VA) can occur after blunt trauma or iatrogenically during surgery. Clinicians should be aware of anatomic variants VA, presence which may increase risk iatrogenic VA (VAI).If VAI is suspected following trauma, rapid identification via advanced imaging modalities, such as computed tomography angiography, help clarify site and guide management.VAI classified according Denver grading scale for cerebrovascular injury, ranging from grade I V, includes intimal narrowing, pseudoaneurysm formation, complete occlusion, arterial transection.Treatment modalities remain controversial include anticoagulation, endovascular interventions, surgical tamponade, ligation, microvascular repair. The choice treatment influenced by setting (iatrogenic in operating room versus field) laterality dominant with respect brain perfusion.» (VAI).» If management.» transection.» Treatment perfusion.