Non penetrating trauma to vertebral artery is a known complication in craniovertebral
trauma. They are mainly reported with facet dislocations or injuries involving the
foramen transversarium. Such a type of injury is rarely seen with flexion injuries.
We report such a case leading to cerebellar stroke in a young male presenting to us
with hemiparesis. A 43-year-old male presented to us 1 month post trauma after a motor
vehicular accident with complaint of weakness of right half of the body since the
trauma. He suffered blunt trauma to head and neck and complained of a flail right
upper limb since trauma and weakness of the right lower limb which had partly improved.
He was conservatively managed elsewhere. Radiographic investigations revealed complete
occlusion of the right vertebral injury above the level of 6th cervical vertebra and flexion teardrop fracture of 5th cervical vertebra. He was managed conservatively for the vertebral artery injury
(VAI) and corpectomy of C5 vertebra with anterior cervical plating and fusion. Such
a rare type of injury can present with unexplained neurodeficit which needs appropriate
radiological investigations for diagnosis before ascribing the cause to cord trauma.
Hence, all high velocity motor vehicular accidents with associated fractures and neurodeficit
should be screened for blunt VAIs.
Key-words:
Blunt vertebral artery injury - cerebellar stroke - flexion teardrop fracture - vertebral
artery thrombosis
