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Vertebral Artery Injury Associated with a Jefferson Fracture

Published online by Cambridge University Press:  18 September 2015

Gregory S. Walsh  and
Michael D. Cusimano
Gregory S. Walsh
Affiliation:
Division of Neurosurgery, St. Michael’s Hospital, University of Toronto, Toronto
Michael D. Cusimano*
Affiliation:
Division of Neurosurgery, St. Michael’s Hospital, University of Toronto, Toronto
*
Division of Neurosurgery, 38 Shuter Street, Toronto, Ontario, Canada M5B 1A6
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Abstract

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Background

The evaluation and treatment of Jefferson fractures, a burst fracture of the ring of CI, has been well documented in the medical literature. Vertebral artery injury associated with a Jefferson fracture is very rare.

Methods

The case study technique was used to summarize the case. Review of the literature was performed to discuss the case. Retrospective chart review of the 174 patients with cervical fractures admitted to St. Michael’s Hospital from 1989–1994 was also performed.

Results

The case of a patient with a Jefferson fracture, with bilateral lateral displacement of the lateral masses causing bilateral vertebral artery occlusions resulting in a lateral medullary and cerebellar infarction is reported. A review of the literature is provided.

Conclusion

A high index of suspicion for this injury is paramount, especially in patients with multiple trauma, where the diagnosis of Jefferson fractures can be delayed.

Résumé

Résumé<span class='italic'><span class='bold'>Introduction</span></span>

L’évaluation et le traitement des fractures de Jefferson, une fracture par éclatement de l’anneau de Cl, sont bien documentés dans la littérature médicale. Il est très rare qu’une lésion de l’artère vertébrale soit associée à une fracture de Jefferson.

<span class='italic'><span class='bold'>Méthodes</span></span>

Nous présentons une étude de cas ainsi qu’une revue de la littérature pour en discuter. Nous avons également révisé les dossiers de 174 patients ayant subi des fractures cervicales qui ont été admis à l’Hôpital St-Michael entre 1989 et 1994.

<span class='italic'><span class='bold'>Résultats</span></span>

Nous rapportons le cas d’un patient avec fracture de Jefferson et déplacement latéral bilatéral des masses latérales causant un infarcissement médullaire et cérébelleux suite à une occlusion bilatérale des artères vertébrales. Nous présentons également une revue de la littérature.

<span class='italic'><span class='bold'>Conclusions</span></span>

Il est très important de considérer cette éventualité, surtout chez les polytraumatisés chez qui le diagnostic de fracture de Jefferson peut être tardif.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 22 , Issue 4 , November 1995 , pp. 308 - 311
Copyright
Copyright © Canadian Neurological Sciences Federation 1995

References

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