Treatment strategy for a penetrating stab wound to the vertebral artery: a case report. Issue 1 (28th November 2018)

• Record Type: Journal Article
• Authors: Yaguchi, Shinya; Yamamura, Hitoshi; Kamata, Kousuke; Shimamura, Norihito; Kakehata, Shinya; Matsubara, Atsushi
• Is Part Of: Acute medicine & surgery. Volume 6:Issue 1(2019)
• Page Start: 83
• Page End: 86
• Publication Date: 2018-11-28
• Subjects: Computed tomography angiography -- penetrating stab injury -- root injury -- transcatheter arterial embolization -- vertebral artery injury; Surgery -- Periodicals; Medical emergencies -- Periodicals; 617.005
• DOI: 10.1002/ams2.381
• Languages: English
• ISSNs: 2052-8817

Abstract

Abstract : Case: Vertebral artery injury is a low‐frequency but high‐mortality injury. The surgical approach to a bleeding vertebral artery injury is one of the most difficult procedures in trauma surgery. A 64‐year‐old woman was transported to our emergency department after being stabbed in the middle side of the right neck with a large kitchen knife. Her initial hospital examination indicated a shock state, and computed tomography images revealed a right vertebral artery injury. We undertook angiography and transcatheter arterial embolization before the surgical operation. Outcome: The patient suffered right upper extremity paralysis due to brachial plexus injury and was transferred to another hospital for rehabilitation on the 24th hospital day. Conclusion: Computed tomography angiography for diagnosis and interventional radiology treatment are useful for the management of penetrating neck trauma. Transcatheter arterial embolization for vertebral artery injury is safe and allows for easy control of bleeding compared to a surgical procedure. Abstract : Computed tomography of the neck of a 64‐year‐old woman who was stabbed in the middle side of the right neck with a large kitchen knife. The knife edge passed near the right common carotid artery and jugular vein (circle) and injured the right vertebral artery (arrow).