Abstract
We describe a case of penetrating injury to the vertebral artery that was treated with transcather arterial embolization. A 39-year-old man was brought to our emergency department with a self-inflicted stab wound to the left side of his neck. He showed no active external hemorrhage on arrival. However, massive bleeding occurred while computed tomography was being performed. Wound exploration revealed massive pulsatile bleeding around the transverse process of the vertebra (C5), which could not be stopped by direct approach. An injury of the left vertebral artery was suspected. Therefore, further angiographic evaluation was performed, and the injury was secured. The proximal part of the vertebral artery was occluded with transcatheter arterial embolization. In general, the requirement of surgical management in patients with Zone II penetrating neck injury can be evaluated by physical examination; however, penetrating vertebral artery injury which required surgical management cannot be detected in some cases because of anatomical features. If the path of the penetrating agent appears to be in proximity to the vertebral arteries, angiography or other radiographic evaluations should be performed.
