Background: Vertebral injury after blunt cerebrovascular injury remains an underdiagnosed clinical entity. Its relatively indolent course may not raise physicians’ suspicions and inadequate screening may be used. Even in cases, whereby it is confirmed with an angiographic examination, further dilemmas ensue regarding the administration of antithrombotic medication and the period
of time when trauma treatment should take place.
Case Series: Herewith, we report of four patients who were treated in our clinic. Two of them suffered a subluxation warranting surgical reduction andanterior stabilization with plate and screws preceded by low- molecular-weight heparin administration. Both of them had intact motoric function of their upper extremities. The other two patients required no surgical procedure for their trauma
and antithrombotic treatment initiated after completion of digital subtraction angiography.
Conclusions: We support that a scheduled operation should not dissuade surgeons from administrating antithrombotic treatment. A definite operative treatment for underlying cervical spine trauma should be delayed until high risk period for stroke has passed, if no severe neurological deficit exists. Computed tomography angiography is an adequate, time and cost-effective method for VAI screening and diagnosis. As long as, no strong recommendations exist multicenter prospective trials have to be conducted.

PDF (Download Full text)