2020 年 43 巻 1 号 p. 28-32
The case was a 65–year–old male. The patient fell from a stepladder and was injured. Computed tomography revealed a fracture extending to the left lateral foramen in the 6th cervical spine, and 3DCTA revealed occlusion of the left cervical vertebral artery, basilar artery, and posterior cerebral artery. Revascularization therapy was performed with a diagnosis of cerebral infarction due to cerebral main artery occlusion of unknown onset time. A 6Fr guiding catheter was placed in the left vertebral artery, and thrombus crushing and thrombus collection were performed using a stent–type thrombectomy device. After the operation, the disturbance of consciousness improved.
The vertebral artery dissection associated with trauma often accompanies cerebral infarction, and a lucid interval of several hours to several weeks is observed before the onset of symptoms. Neck pain after trauma requires careful observation considering the possibility of vascular dissection. When neurological symptoms appear, vascular assessment should be performed promptly, and revascularization therapy should be considered if indicated.