Endovascular treatment for a penetrating vertebral artery injury

Abstract

The vertebral artery injuries are rare in frequency and penetrating injuries are most likely to damage the vertebral artery as a sort of a collateral damage from striking the bony cervical spine. A 49-year-old man was struck in the face with a metal bar. The plain skull X-ray showed a long nail penetrating from the maxilla to the suboccipital area. Digital subtraction angiography revealed an injury of the left vertebral artery with a strong retrograde flow down the rostral segment and a filling with thrombus within the distal portion from injured segment. The patient underwent Guglielmi detachable coils embolization for complete isolation of the injured segment. The manual removal of the foreign body was attempted and was successfully completed.