Traumatic Dissection of Four Brain-Supplying Arteries without Neurologic Deficit

摘要

>Study Design Case report and review of the literature. >Objectives Case report of a traumatic dissection of all major brain-supplying arteries resulting from a horseback-riding accident. Overview of the literature on diagnostic and therapeutic recommendations. >Methods Case presentation. For the discussion, handpicked articles and PubMed database research with the keywords “dissection,” “vertebral artery,” “spine trauma,” “computed tomography,” “magnetic resonance imaging,” and “angiography” were used. >Results Despite high-energy induced acute lesion of all four cervical arteries, this 45-year-old patient did not demonstrate signs of microemboli nor suffer from stroke. >Conclusion In case of high-energy trauma of the head and/or the neck, emergency physicians must consider traumatic cervical artery dissection (TCAD). Thus, emergency care algorithms should routinely include computed tomography angiography and magnetic resonance imaging. Although the incidence of TCAD-induced stroke is low, antiplatelet therapy is recommended in the presence of TCAD.