Vertebral and basilar artery thrombosis following cervical spine injury

Vertebral artery injury may complicate cervical spine injury and may result in severe neurological impairment. We present a case of a 54 year-old male who sustained a hyperextension injury of the neck during horseback riding with cervical spine dislocation of C3/4. As a consequence of right-sided traumatic vertebral artery thrombosis and extension of the thrombus into the basilar artery the patient developed a brainstem and bilateral cerebellar infarction with fatal outcome. In a review of the literature the characteristics of 33 cases with vertebral artery injuries following cervical spine trauma and with associated neurological complications are described. The problems of vertebral artery injury are discussed concerning diagnosis and therapy.