Study Sheds Light On Vertebral Artery Injuries After Auto Collisions
A vertebral artery injury (VAI) indicates damaged arteries in the back of the neck. If you have a dull or throbbing pain in this region after an auto collision or other trauma, it could be a sign of VAI. As the head rapidly extends during an auto collision, substantial strain is placed on the structures within the neck, which can injure the vertebral arteries.
This is a potentially life-threatening problem. Associated with cervical trauma, VAI is being increasingly diagnosed through aggressive screening. However, little is known about the significance, natural history, and most effective treatment methods for VAI.
To add to the understanding of VAI, a research team recently performed a retrospective review of vertebral artery injuries treated at a level one trauma center over the past ten years. Fifty-one patients with VAI were identified out of a total of 36,942 trauma patients (0.13% occurrence).
All VAI injuries were classified according to laterality, Denver grading scale, and segmental involvement. Researchers also analyzed demographics, associated injuries, treatment plans, and neurological outcomes. Associated injuries tended to be severe; cervical spine fracture was present in 88% of patients with VAI. Treatments provided for VAI included antiplatelet therapy (50%), observation (31%), warfarin (17%), and stent (2%). Morbidity was found to be 8%, primarily in patients with significant injuries to internal organs. The researchers suggest a conservative approach, with either observation or antithrombotic therapy, for treating VAI in severely-injured trauma patients.
Alterman DM, et al. Contemporary outcomes of vertebral artery injury: A 10-year single-center experience. Journal of Vascular Surgery 2012. pii: S0741-5214(12)01946-5. doi: 10.1016/j.jvs.2012.09.006.