Stab Wounds at the Craniocervical Junction

Neurosurgery ◽  
1985 ◽  
Vol 17 (6) ◽  
pp. 930-936 ◽  
Author(s):  
J.C. de Villiers ◽  
A. R. Grant
Keyword(s):  
Vertebral Artery ◽  
Surgical Repair ◽  
False Aneurysm ◽  
Craniocervical Junction ◽  
Artery Occlusion ◽  
Cerebrospinal Fluid Leakage ◽  
Warning Sign ◽  
Upper Limbs ◽  
Stab Wounds ◽  
Anatomical Features

Abstract Between 1976 and 1984, 11 patients with stab wounds at the craniocervical junction were seen in the Department of Neurosurgery at Groote Schuur Hospital. The injury usually occurred in males, and the left side was predominantly involved. Because of the anatomical features of this region, the penetrating instrument is deflected by the occipital squama into the atlantooccipital or atlantoaxial interspace, and an almost predictable syndrome occurs. The dura mater is penetrated, so that cerebrospinal fluid leakage and meningitis are common complications (meningitis occurred in 5 patients). A meningocele may develop at this site and did occur in 4 patients, but only 2 required surgical repair. Because of the exposed position of the vertebral artery at this level, this vessel was injured in 4 patients; an arteriovenous fistula developed in 2, vertebral artery occlusion occurred in 1, and a false aneurysm developed in another patient. The neurological deficit varied in magnitude, was often transient, affected the upper limbs more than the lower, was asymmetrical (suggestive of lateralized injury), and at times showed a remarkable tendency to recover. Awareness of the existence of this syndrome may help in forestalling complications. The only warning sign may be an insignificant wound in the suboccipital or retromastoid region.

Traumatic Pseudoaneurysm of the Left Ventricle

1996 ◽  
Vol 4 (4) ◽  
pp. 236-237
Author(s):  
Rajendra Kumar Premchand ◽  
Rakesh Arora ◽  
Rakesh Sudhan ◽  
Vasantha Kumar Allam ◽  
Padmanabhan Tirumalai Nallan Chakravarthi ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Surgical Repair ◽  
False Aneurysm ◽  
Coronary Artery Occlusion ◽  
Artery Occlusion ◽  
Myocardial Contusion ◽  
Traumatic Pseudoaneurysm

A pseudoaneurysm of the left ventricle developed in an 11-year-old boy following a trivial blunt trauma to the chest wall. This was detected by echocardiography 3 months after the injury. An echocardiogram performed 2 weeks after the injury demonstrated intact chambers. The false aneurysm resulted from myocardial contusion with subsequent gradual rupture of the left ventricle without coronary artery occlusion. The patient underwent a successful surgical repair. This case demonstrates the need for careful follow-up of all patients sustaining blunt chest trauma.

scholarly journals Vertebral Artery Occlusion in Duplex Color-Coded Ultrasonography

Stroke ◽  
2004 ◽  
Vol 35 (5) ◽  
pp. 1068-1072 ◽  
Author(s):  
Kozue Saito ◽  
Kazumi Kimura ◽  
Kazuyuki Nagatsuka ◽  
Keiko Nagano ◽  
Kazuo Minematsu ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Artery Occlusion ◽  
Vertebral Artery Occlusion

Deliberate basilar or vertebral artery occlusion in the treatment of intracranial aneurysms

1993 ◽  
Vol 79 (2) ◽  
pp. 161-173 ◽  
Author(s):  
Gary K. Steinberg ◽  
Charles G. Drake ◽  
Sydney J. Peerless
Keyword(s):  
Clinical Outcome ◽  
Vertebral Artery ◽  
Brain Stem ◽  
Intracranial Aneurysms ◽  
Artery Occlusion ◽  
Neurological Deterioration ◽  
Content Type ◽  
Vertebrobasilar Junction ◽  
Aneurysm Thrombosis ◽  
Fine Print

✓ Deliberate occlusion of the basilar or vertebral arteries was performed in 201 patients with intracranial aneurysms, where the aneurysmal neck could not be clipped directly. The aneurysms arose from the basilar apex in 83 cases, the basilar trunk in 46, the vertebrobasilar junction in 35, and the vertebral artery in 37; 87% of the aneurysms were classified as giant lesions (> 2.5 cm). There were 85 upper basilar occlusions, 41 lower basilar occlusions, 29 bilateral vertebral occlusions, and 48 unilateral vertebral artery occlusions. The clinical follow-up period varied from 1 to 23 years, with a mean of 9.5 years. Overall long-term results were excellent in 68% of the patients, good in 5%, and poor in 3%; 24% died. Clinical outcome varied according to aneurysm site; excellent or good results were achieved in 64% of the patients with basilar apex, 76% with basilar trunk, 74% with vertebrobasilar junction, and 87% with vertebral artery aneurysms. Clinical outcome also varied depending on preoperative grade: 86% of the patients with an excellent presenting grade achieved excellent results. The size of the posterior communicating arteries was a good predictor of tolerance to basilar artery occlusion (p < 0.05). Successful aneurysm thrombosis was achieved in 78% of the patients. The neurological status in 26 patients (13%) deteriorated due to vertebrobasilar ischemia occurring within the 1st postoperative week, and thrombosis or embolism was implicated much more frequently than hemodynamic insufficiency. Subarachnoid hemorrhage (SAH) in 14 patients, vasospasm in five patients, and surgical trauma in seven patients accounted for additional morbidity in the 1st month following operation; however, many of these patients ultimately made an excellent recovery. Late vertebrobasilar ischemic complications or neurological deterioration from persistent mass effect occurred in 4% of patients with successful aneurysm thrombosis 6 weeks to 18 months after arterial ligation. Among the 43 patients with incompletely thrombosed aneurysms, 67% developed early or late neurological deterioration from SAH, progressive brain-stem compression, or brain-stem stroke, with 86% of the complications proving fatal.

scholarly journals Vertebral artery occlusion associated with blunt traumatic cervical spine injury

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Youhei Nakamura ◽  
Kenji Kusakabe ◽  
Shota Nakao ◽  
Yasushi Hagihara ◽  
Tetsuya Matsuoka
Keyword(s):  
Cervical Spine ◽  
Vertebral Artery ◽  
Cervical Spine Injury ◽  
Artery Occlusion ◽  
Spine Injury ◽  
Vertebral Artery Occlusion

Clinical Application of Scalp Cluster Needling Combined with Bobath Technique in Upper Limb Spastic Paralysis After Stroke of Vertebral Artery Type

2021 ◽  
Author(s):  
Aimin Gong ◽  
Mengjie Zeng ◽  
Zhiquan Wu
Keyword(s):  
Treatment Group ◽  
Acupuncture Therapy ◽  
Vertebral Artery ◽  
Upper Limb ◽  
Training Group ◽  
Control Group ◽  
Upper Limbs ◽  
Spastic Paralysis ◽  
Rehabilitation Training ◽  
The Difference

To observe the difference in clinical effects of scalp-point cluster acupuncture combined with rehabilitation training in treating spastic paralysis of upper limbs after stroke. Using a randomized controlled design, 96 patients with upper limb spastic paralysis after stroke were randomly divided into two groups: treatment group (scalp acupuncture plus rehabilitation training group 48 cases), control group (rehabilitation training group 48 cases). After 2 courses of treatment, it was judged by observing clinical efficacy evaluation, Ashworth classification, and Fugl-Meyer (FMA) score. The total effective rate was 91.7% in the treatment group and 68.7% in the control group; the difference between the two groups was statistically significant (P <0.05). Before treatment, the difference in Ashworth classification between the two groups was not statistically significant (P> 0.05); after treatment, the difference between the two groups was statistically significant (P <0.01). After treatment, the difference between the two groups was statistically significant (P＜0.05). The Fugl-Meyer (FMA) scores of the two groups of patients before treatment were comparable (P>0.05), and there were significant differences between the two groups after treatment (P <0.05). The difference of Fugl-Meyer (FMA) scores between the two groups was statistically significant (P < 0.01). Scalp cluster acupuncture therapy is more effective than traditional acupuncture therapy alone in treating vertebral artery type cervical spondylosis. Scalp cluster acupuncture combined with Bobath technique is effective in treating spastic paralysis of upper limbs after stroke, and it is worthy of clinical application.

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