Post-traumatic occlusion in vertebro-basilar system: report of two cases

ABSTRACT

OccIusions of the vertebral and basilar arteries following trauma are uncommon occurrences. Most patients present with brain stem or cerebellar dysfunction and although four vessel angiography is essential for localising the anatomic diagnosis, computed tomography of the head [CT head] is helpful in showing associated changes such as infarction, haemorrhage or hydrocephalus. Two cases form the basis of the present report. One patient developed occlusion of the cervical vertebral artery following a gun shot injury and presented with Brown Sequard syndrome and the other patient, who was treated initially for a left frontal extradural haematoma, later developed acute coma eight weeks following the injury. Angiography showed vertebro-basilar dissection, occlusion and posterior inferior cerebellar artery [PICA] pseudo-aneurysm, and computer tomography showed subarachnoid and intraventricular haemorrhage and left cerebellar infarction