Incidence and outcomes of posterior circulation stroke following traumatic vertebral artery injury: A 6-year single-center retrospective cohort study.

Abstract

Objectives: Vertebral artery injury (VAI) is an uncommon, but potentially devastating, complication following cervical spine trauma. Posterior circulation ischemia (POCS) can result from a disruption to the vertebral arteries and potentially lead to long-term morbidity and mortality for these patients. This study aimed to describe the outcomes for patients with POCS as a result of VAI.

Methods: Six hundred and twenty patients who sustained a cervical spine fracture with or without dislocation were identified from the years 2011 to 2017. Demographic data, injury details, and imaging results were collected with inpatient and outpatient records on the regional electronic care record. Patients with VAI were identified (n = 20) and screened for subsequent POCS. Their outcome was recorded from inpatient and outpatient records.

Results: POCS was identified in 6 patients who had sustained a VAI (30%). Of those 6 patients, 5 had long-term neurological deficits following their injury and POCS. Two patients died within 30 days and 3 patients had died by 60 days following injury.

Conclusions: POCS occurred in 30% of patients who sustained a VAI in this study. It carried significant morbidity and mortality for the patients who suffered this potentially devastating complication. Clinicians involved in the care of patients with cervical spine trauma should be aware of the risk factors for VAI and ensure to be suspicious of POCS in patients who have proven VAI.