caa a22 4500 445832401 CHVBK 20180317145319.0 cr unu---uuuuu 170323e20111201xx s 000 0 eng 10.1007/s00586-011-1887-2 doi (NATIONALLICENCE)springer-10.1007/s00586-011-1887-2 Vertebral artery injuries following cervical spine trauma: a prospective observational study [Elektronische Daten] [Christian-Andreas Mueller, Inga Peters, Martin Podlogar, Attila Kovacs, Horst Urbach, Karl Schaller, Johannes Schramm, Thomas Kral] Purpose: The purpose of this study was to report on the incidence, diagnosis and clinical manifestation of VAI following cervical spine injuries observed in a prospective observational study with a standardized clinical and radiographical protocol. Methods: During a 16-year period, 69 (mean age: 43±20.7years; 25 female, 44 male) of 599 patients had cervical spine injury suspicious for VAI due to facet luxation and/or fractures extending into the transverse foramen. Diagnosis and management of these patients followed a previously published protocol (Kral in Zentralbl Neurochir 63:153-158, 2002). Digital subtraction angiography (DSA) was performed in all 69 patients. Injury grading of VAI was done according to Biffl et al. (Ann Surg 231:672-681, 2000). All patients with VAI were treated with anticoagulation (heparin followed by ASS) for 6months. Results: In cases suspicious for VAI, the incidence of VAI detected by DSA was 27.5% (n=19 of 69 patients). VAI Grade I occurred in 15.8%, Grade II in 26.3%, Grade IV in 52.6% and Grade V in 5.2%. Of 19 patients, 4 (21%) had clinical signs of vertebrobasilar ischemia. Two patients died in hospital after 4 and 21days respectively. Of 69 patients, 33 (47.8%) with suspected VAI had unstable spine injuries and were treated surgically. Conclusion: In patients with cervical spine fractures or dislocations crossing the course of the vertebral artery, VAI are relatively frequent and may be associated with significant morbidity and mortality. VAI were identified by DSA in 27.5%. Despite anticoagulation therapy, 5.8% became clinically symptomatic and 2.9% died due to cerebrovascular ischemia. Springer-Verlag, 2011 Vertebral artery injury nationallicence Arteriography nationallicence Cervical spine trauma nationallicence CT-angiography nationallicence MR-angiography nationallicence Mueller Christian-Andreas Department of Neurosurgery, Rheinische Friedrich-Wilhelms Universität Bonn, Sigmund-Freud Str. 25, 53105, Bonn, Germany aut Peters Inga Department of Neurosurgery, Rheinische Friedrich-Wilhelms Universität Bonn, Sigmund-Freud Str. 25, 53105, Bonn, Germany aut Podlogar Martin Department of Neurosurgery, Rheinische Friedrich-Wilhelms Universität Bonn, Sigmund-Freud Str. 25, 53105, Bonn, Germany aut Kovacs Attila Department of Radiology and Neuroradiology, Rheinische Friedrich-Wilhelms Universität Bonn, Bonn, Germany aut Urbach Horst Department of Radiology and Neuroradiology, Rheinische Friedrich-Wilhelms Universität Bonn, Bonn, Germany aut Schaller Karl Department of Neurosurgery, Rheinische Friedrich-Wilhelms Universität Bonn, Sigmund-Freud Str. 25, 53105, Bonn, Germany aut Schramm Johannes Department of Neurosurgery, Rheinische Friedrich-Wilhelms Universität Bonn, Sigmund-Freud Str. 25, 53105, Bonn, Germany aut Kral Thomas Department of Neurosurgery, Rheinische Friedrich-Wilhelms Universität Bonn, Sigmund-Freud Str. 25, 53105, Bonn, Germany aut European Spine Journal Springer-Verlag 20/12(2011-12-01), 2202-2209 0940-6719 20:12<2202 2011 20 586 https://doi.org/10.1007/s00586-011-1887-2 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00586-011-1887-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Mueller Christian-Andreas Department of Neurosurgery, Rheinische Friedrich-Wilhelms Universität Bonn, Sigmund-Freud Str. 25, 53105, Bonn, Germany aut NATIONALLICENCE 700 1- Peters Inga Department of Neurosurgery, Rheinische Friedrich-Wilhelms Universität Bonn, Sigmund-Freud Str. 25, 53105, Bonn, Germany aut NATIONALLICENCE 700 1- Podlogar Martin Department of Neurosurgery, Rheinische Friedrich-Wilhelms Universität Bonn, Sigmund-Freud Str. 25, 53105, Bonn, Germany aut NATIONALLICENCE 700 1- Kovacs Attila Department of Radiology and Neuroradiology, Rheinische Friedrich-Wilhelms Universität Bonn, Bonn, Germany aut NATIONALLICENCE 700 1- Urbach Horst Department of Radiology and Neuroradiology, Rheinische Friedrich-Wilhelms Universität Bonn, Bonn, Germany aut NATIONALLICENCE 700 1- Schaller Karl Department of Neurosurgery, Rheinische Friedrich-Wilhelms Universität Bonn, Sigmund-Freud Str. 25, 53105, Bonn, Germany aut NATIONALLICENCE 700 1- Schramm Johannes Department of Neurosurgery, Rheinische Friedrich-Wilhelms Universität Bonn, Sigmund-Freud Str. 25, 53105, Bonn, Germany aut NATIONALLICENCE 700 1- Kral Thomas Department of Neurosurgery, Rheinische Friedrich-Wilhelms Universität Bonn, Sigmund-Freud Str. 25, 53105, Bonn, Germany aut NATIONALLICENCE 773 0- European Spine Journal Springer-Verlag 20/12(2011-12-01), 2202-2209 0940-6719 20:12<2202 2011 20 586 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer