Bilateral vertebral artery injury leads to brain death following traumatic brain injury: a case report
Abstract Background Vertebral artery injury is a rare condition in trauma settings. In the advanced stages, it causes death. Case A 31-year-old Sundanese woman with cerebral edema, C2–C3 anterolisthesis, and Le Fort III fracture after a motorcycle accident was admitted to the emergency room. On the...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-03-01
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| Series: | Journal of Medical Case Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13256-024-04432-3 |
| _version_ | 1827315953329766400 |
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| author | Vera Irawany Vizzi A. F. Nasution Noorcahya Amalia |
| author_facet | Vera Irawany Vizzi A. F. Nasution Noorcahya Amalia |
| author_sort | Vera Irawany |
| collection | DOAJ |
| description | Abstract Background Vertebral artery injury is a rare condition in trauma settings. In the advanced stages, it causes death. Case A 31-year-old Sundanese woman with cerebral edema, C2–C3 anterolisthesis, and Le Fort III fracture after a motorcycle accident was admitted to the emergency room. On the fifth day, she underwent arch bar maxillomandibular application and debridement in general anesthesia with a hyperextended neck position. Unfortunately, her rigid neck collar was removed in the high care unit before surgery. Her condition deteriorated 72 hours after surgery. Digital subtraction angiography revealed a grade 5 bilateral vertebral artery injury due to cervical spine displacement and a grade 4 left internal carotid artery injury with a carotid cavernous fistula (CCF). The patient was declared brain death as not improved cerebral perfusion after CCF coiling. Conclusions Brain death due to cerebral hypoperfusion following cerebrovascular injury in this patient could be prevented by early endovascular intervention and cervical immobilisation. |
| first_indexed | 2024-04-24T23:05:35Z |
| format | Article |
| id | doaj.art-17a1989835d5403ba72deae2f74a2cb0 |
| institution | Directory Open Access Journal |
| issn | 1752-1947 |
| language | English |
| last_indexed | 2024-04-24T23:05:35Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj.art-17a1989835d5403ba72deae2f74a2cb02024-03-17T12:27:16ZengBMCJournal of Medical Case Reports1752-19472024-03-011811610.1186/s13256-024-04432-3Bilateral vertebral artery injury leads to brain death following traumatic brain injury: a case reportVera Irawany0Vizzi A. F. Nasution1Noorcahya Amalia2Fatmawati National General HospitalAnesthesiology and Intensive Care Department, Faculty of Medicine, Universitas IndonesiaFatmawati National General HospitalAbstract Background Vertebral artery injury is a rare condition in trauma settings. In the advanced stages, it causes death. Case A 31-year-old Sundanese woman with cerebral edema, C2–C3 anterolisthesis, and Le Fort III fracture after a motorcycle accident was admitted to the emergency room. On the fifth day, she underwent arch bar maxillomandibular application and debridement in general anesthesia with a hyperextended neck position. Unfortunately, her rigid neck collar was removed in the high care unit before surgery. Her condition deteriorated 72 hours after surgery. Digital subtraction angiography revealed a grade 5 bilateral vertebral artery injury due to cervical spine displacement and a grade 4 left internal carotid artery injury with a carotid cavernous fistula (CCF). The patient was declared brain death as not improved cerebral perfusion after CCF coiling. Conclusions Brain death due to cerebral hypoperfusion following cerebrovascular injury in this patient could be prevented by early endovascular intervention and cervical immobilisation.https://doi.org/10.1186/s13256-024-04432-3Cerebrovascular traumaCarotid artery injuryDigital subtraction angiographySpondylolisthesisCervical vertebrae |
| spellingShingle | Vera Irawany Vizzi A. F. Nasution Noorcahya Amalia Bilateral vertebral artery injury leads to brain death following traumatic brain injury: a case report Journal of Medical Case Reports Cerebrovascular trauma Carotid artery injury Digital subtraction angiography Spondylolisthesis Cervical vertebrae |
| title | Bilateral vertebral artery injury leads to brain death following traumatic brain injury: a case report |
| title_full | Bilateral vertebral artery injury leads to brain death following traumatic brain injury: a case report |
| title_fullStr | Bilateral vertebral artery injury leads to brain death following traumatic brain injury: a case report |
| title_full_unstemmed | Bilateral vertebral artery injury leads to brain death following traumatic brain injury: a case report |
| title_short | Bilateral vertebral artery injury leads to brain death following traumatic brain injury: a case report |
| title_sort | bilateral vertebral artery injury leads to brain death following traumatic brain injury a case report |
| topic | Cerebrovascular trauma Carotid artery injury Digital subtraction angiography Spondylolisthesis Cervical vertebrae |
| url | https://doi.org/10.1186/s13256-024-04432-3 |
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