Iatrogenic Vertebral Artery Injury

This section is compiled by Frank M. Painter, D.C.
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WARNING: Conducting an Orchestra Can Cause Vertebral Artery Dissection:
"Ostrich Sign" Indicates Bilateral Vertebral Artery Dissection

Journal of Stroke and Cerebrovascular Diseases 2011 (Mar 24) [Epub ahead of print]

Vertebral artery dissections (VADs) comprise about 2% of ischemic strokes and can be associated with trauma, chiropractic manipulation, motor vehicle collisions, whiplash, amusement park rides, golfing, and other motion-induced injuries to the neck. We present a case of bilateral extracranial VAD as a complication of conducting an orchestra. To our knowledge, this has not been documented in the literature. Conceivably, vigorous neck twisting in an inexperienced, amateur conductor may place excessive rotational forces upon mobile portions of the verterbral arteries, tear the intima, deposit subintimal blood that extends longitudinally, and cause neck pain and/or posterior fossa ischemic symptoms.

End-to-End Anastomosis of an Unanticipated Vertebral Artery Injury
During C2 Pedicle Screwing

J Korean Neurosurg Soc. 2010 (Oct);   48 (4):   363366

Vertebral artery (VA) injury is a rare and serious complication of cervical spine surgery; this is due to difficulty in controlling hemorrhage, which can result in severe hypotension and cardiac arrest, and uncertain neurologic consequences. The authors report an extremely rare case of a 56-year-old woman who underwent direct surgical repair by end-to-end anatomosis of an unanticipated VA injury during C2 pedicle screwing.

Vertebral Artery Dissection After Iatrogenic
Cervical Subcutaneous Emphysema

J Card Surg. 2011 (Jan);   26 (1):   5456

We report a case of spontaneous vertebral artery dissection (VAD) in a patient who developed extensive subcutaneous emphysema following the removal of a chest tube after a cardiac transplant. The pathophysiology and management of this uncommon complication are reviewed. Although vertebral and carotid artery dissections are unusual events occurring in 2.5 to 3 per 100,000 people, they are increasingly acknowledged to be important causes of stroke in the young and middle-aged adult population accounting for up to 25% of such cases.

Injury of an Aberrant Vertebral Artery During a Routine Corpectomy:
A Case Report and Literature Review

Spinal Cord. 2009 (Oct);   47 (10):   773775

A case report of a 58-year-old man who sustained a laceration of his left vertebral artery during a routine corpectomy for cervical myelopathy is reported.

Vertebral Artery Injury in Cervical Spine Surgery:
Anatomical Considerations, Management, and Preventive Measures

Spine J. 2009 (Jan-Feb);   9 (1):   7076

Vertebral artery (VA) injury can be a catastrophic iatrogenic complication of cervical spine surgery. Although the incidence is rare, it has serious consequences including fistulas, pseudoaneurysm, cerebral ischemia, and death. It is therefore imperative to be familiar with the anatomy and the instrumentation techniques when performing anterior or posterior cervical spine surgeries.

Review PubMed For Other Medical Causes of Vertebral Artery Injury


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