Article Dans Une Revue Neurochirurgie Année : 2024

Fractured cervical spine, dissected vertebral artery, and life-threatening stroke: A challenging case report and literature review

Anis Choucha
Thomas Barraque
  • Fonction : Auteur
Mikael Meyer
  • Fonction : Auteur
Henry Dufour
  • Fonction : Auteur
Kaissar Farah
  • Fonction : Auteur
Stephane Fuentes
  • Fonction : Auteur

Résumé

Introduction: Vertebral artery injury (VAI) following blunt trauma can lead to acute or delayed life-threatening posterior fossa ischemic stroke. Its management raises controversial issues and is still open to debate. Material & method: We report the case of a 48-year-old male who presented a life-threatening posterior circulation ischemic stroke, secondary to a vertebral artery dissection caused by a cervical spine fracture. This case was successfully managed through intravenous thrombolysis and endovascular thrombectomy followed by antiplatelet therapy and an anterior cervical discectomy and fusion. At the one-year follow-up, the patient had no persisting deficit and was back working as a policeman. Conclusion: Rapid management of patients with dramatic clinical presentation can lead to full recovery. Implications include a systematic screening of blunt trauma VAI through computed tomography angiography when dealing with high-risk cervical spine fractures; patients harboring both a cervical spine fracture and a VAI must be transferred to a tertiary referral hospital able to deal both with strokes and cervical spine surgery to ensure responsiveness in case of stroke.

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hal-04955762 , version 1 (19-02-2025)

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Anis Choucha, Thomas Barraque, Mikael Meyer, Henry Dufour, Kaissar Farah, et al.. Fractured cervical spine, dissected vertebral artery, and life-threatening stroke: A challenging case report and literature review. Neurochirurgie, 2024, 70 (4), pp.101561. ⟨10.1016/j.neuchi.2024.101561⟩. ⟨hal-04955762⟩
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