A CASE OF PENETRATING STAB WOUND THAT INJURED THE VERTEBRAL ARTERY AND INDUCED CEREBELLAR INFARCTION : A CASE REPORT

Abstract

　　A 74-year-old man was brought to our center with a self-inflicted penetrating stab wound on the left side of his neck. As marked external hemorrhage was present in Zone II of his neck on arrival, we performed temporary hemostasis for the neck stab wound and operated again on day 2. However, he developed cerebellar symptoms following the surgery and imaging studies revealed cerebellar infarction. A fragment of the knife was left between C5 and C6, which had damaged the left vertebral artery and induced cerebellar infarction. As the location of the fragment was anatomically challenging and removal may have caused uncontrollable hemorrhage, we performed conservative treatment. He was discharged on day 58 without complications such as rebleeding, pseudoaneurysm, and infection. Patients with Zone II penetrating neck injury should be evaluated for vertebral artery injury by CT and angiography confirming the entire trajectory of the object.