Bilateral vertebral artery occlusion after traumatic complete disruption of the cervical spine associated with ankylosing spondylitis

Ulus Travma Acil Cerrahi Derg. 2021 Nov;27(6):697-701. doi: 10.14744/tjtes.2020.63679.


Bilateral vertebral artery occlusion is an uncommon and mortal injury that could be seen after high-energy traumas. We illustrate an extreme case of bilateral vertebral artery occlusion following traumatic cervical disruption with complete spinal cord injury in a patient with ankylosing spondylitis. A 49-year-old male was admitted to our emergency department after a motor vehicle accident. The American Spinal Injury Association Impairment Scale was a complete A grade. Computed tomography (CT) scan of the cervical region revealed complete disruption between C2 and C3 levels. Magnetic resonance imaging showed apparent compression and narrow calibration of the spinal cord. CT angiography demonstrated occlusion of the bilateral vertebral arteries. Because of the neurological status of the patient, extensive hematoma, and edema at the region, no surgical intervention could be planned. The patient died on the second day of his hospitalization. Only fourteen cases of bilateral vertebral artery occlusion following blunt cervical spine traumas have been reported to date. They have a possibility to cause vertebrobasilar ischemic events with a poor prognosis of morbidity and mortality. The gold standard of diagnosis is the catheter angiography, but also CT angiography has close sensitivity and specificity. The treatment strategies of vertebral artery occlusion are still unclear.

Publication types

  • Case Reports

MeSH terms

  • Cervical Vertebrae / diagnostic imaging
  • Cervical Vertebrae / injuries
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Spinal Injuries*
  • Spondylitis, Ankylosing* / complications
  • Vertebral Artery / diagnostic imaging
  • Vertebral Artery / injuries