A simple method for diagnosing traumatic occlusion of the vertebral artery at the craniovertebral junction

Study Design. A simple method, thin-slice contrast- enhanced computed tomographic (CT) scan, was evaluated as a first-line rapid screening procedure for diagnosing traumatic occlusion of tine vertebral artery et th-e iraniovertsbrâi lunctlon. Objectives. Thie procedure was performed in patients suffering from injuries οΓ the high cervical spine or ths craniovertebral junction. Vertebral angiography was undertaken aftur this procedure to confirm ttie diagnosis. Summary of Dotkgrcund Data. Well-enhanced vertebral arteries can be demonstrated deerly in normal subjects by using thin method, Occlusion of the vertebral artery produces dalayed contrast en-hencement of the proximal artery and abrupt interruption of its course. Methods. Thin-slice CT scan was performed from the atlas to the occipital condyles after an ini rave non 5 injection of ang log raffln. The plane of the CT scan was aligned in a parallel manner to (he upper margin of the atfas. The CT scannfhQ was repeated tint it the contrast enhancement of the vertebral arteries became faint. Results. Occlusion Df the unilateral vertebral artery we& auccessfully diagnoaad in a patient with Jefferson's fracture by using the present technique. A subsequent vertebral angiography confirmed the diagnosis Conclusions. The present technique should be per- formed as a routine screening procedure In patients suffering from injuries to the craniovertebral junction.