Stab wound to the spinal canal at the craniocervical junction with a glass fragment causing pseudoaneurysm of vertebral artery and normal pressure hydrocephalus

Abstract

Background

Non-missile penetrating injuries to the spinal canal are rare in most parts of the world, and their optical management is unclear.

Case presentation

A 57-year-old male fell backwards through a glass bathroom window and a glass fragment penetrated the right side of his neck. Computed tomography revealed a glass fragment traversing the spinal canal at the atlanto-occipital junction. He underwent emergency operation and the glass fragment was withdrawn without obvious bleeding or spinal cord injury. A postoperative magnetic resonance angiography revealed two pseudoaneurysms arising from the right vertebral artery (VA). Two months after the injury, he demonstrated abnormal behavior, including wandering and incontinence. He was diagnosed as normal pressure hydrocephalus (NPH). He underwent right ventriculoperitoneal shunting, and he became fully conscious.

Conclusions

Patients with penetrating injuries to the spinal canal at the craniocervical junction should be closely monitored for complications of VA injury and secondary NPH.