Article ID: 35.3_01
Computed tomography (CT) is useful in the evaluation of patients with penetrating neck injuries. However, in patients with critical conditions, CT is impractical and potentially harmful. We present a case of penetrating vertebral artery injury, which was suspected during direct neck exploration and treated by angioembolization under manual direct pressure hemostasis without prior CT. A 55-year-old man sustained a neck injury from a knife. On arrival at the hospital, he was hemodynamically unstable due to active neck hemorrhage. Immediate exploration of the bleeding wound revealed right internal and external jugular vein injuries. Moreover, right vertebral artery injury was strongly suspected. Although the jugular veins were ligated, the vertebral artery hemorrhage was difficult to surgically control. Therefore, we performed angioembolization under manual pressure hemostasis. Angioembolization under manual pressure hemostasis without prior CT may be a treatment option for critical patients with penetrating vertebral artery injuries.
