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Vertebral Artery Trauma

Opeskin, Kenneth F.R.C.P.A.; Burke, Michael P. F.R.C.P.A., Dip.Forens.Pathol.

American Journal of Forensic Medicine & Pathology:
Articles
Abstract

Vertebral artery trauma is not commonly seen by forensic pathologists. The experience of vertebral artery trauma at the Victorian Institute of Forensic Medicine (30 cases) is summarized and reviewed in the light of the literature. Causes of vertebral artery trauma are discussed. In case 1, the history and timing of the injury raise the question as to whether the vertebral artery dissection occurred before the episode of trauma, that is, was spontaneous or resulted from trauma. Moreover, underlying vertebral artery disease was present, raising the question as to how much trauma was needed to cause vertebral artery dissection. In case 2, despite the history of head/neck trauma, a neurosurgeon considered the subarachnoid hemorrhage was spontaneous, due most likely to ruptured saccular aneurysm or arteriovenous malformation. In case 3, the vertebral artery rupture was not diagnosed in the setting of multiple injuries. Case 4 is an example of prolonged survival with delayed onset of symptoms following vertebral artery trauma. Case 5 is an example of the not uncommon scenario of homicidal vertebral artery trauma accounting for basal subarachnoid hemorrhage, rapid collapse and death. Cases 1 and 4 indicate that relatively normal activity may be possible following vertebral artery trauma in some cases (at least for a time). Cases 1 and 4 are also examples of intracranial vertebral artery dissection.

Author Information

From the Victorian Institute of Forensic Medicine, 57-83 Kavanagh Street, Southbank, 3006 Victoria, Australia.

Received March 24, 1997; accepted October 31, 1997

Address correspondence to Kenneth Opeskin, Victorian Institute of Forensic Medicine, 57-83 Kavanagh Street, Southbank, 3006 Victoria, Australia.

© 1998 Lippincott Williams & Wilkins, Inc.