METHODS: 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.
CONCLUSIONS: 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.
方法:我们报告了一例48岁男性,他出现了危及生命的后循环缺血性卒中,继发于颈椎骨折引起的椎动脉夹层。通过静脉溶栓和血管内血栓切除术,然后进行抗血小板治疗以及颈前路椎间盘切除术和融合术,成功治疗了该病例。在为期一年的随访中,病人没有持续的赤字,回到警察工作。
结论:快速治疗具有戏剧性临床表现的患者可导致完全康复。含义包括在处理高危颈椎骨折时通过计算机断层扫描血管造影对钝性创伤VAI进行系统筛查;同时患有颈椎骨折和VAI的患者必须转移到能够处理中风和颈椎手术的三级转诊医院,以确保中风时的反应能力。