We investigated the appropriateness of performing endovascular treatment for vertebral artery injuries before reduction or surgery for cervical spine injuries combined with bilateral vertebral artery injuries. The subjects were cervical spine injury patients receiving posterior spinal fixation with bilateral vertebral artery injuries at our hospital. There were five cases, and all involved C5-7 spine injury and were treated with posterior cervical spine fixation. The grade of vertebral artery injury was bilateral grade IV in three cases, and grade IV combined with grade I or II in two cases. Coil embolization was performed before spinal surgery for grade IV lesions in four patients, and was not performed in one case. Only one of the four patients who underwent coil embolization had a small new cerebral infarction, but one patient who did not undergo coil embolization died five days after admission. Cervical spine injury with bilateral vertebral artery injury is considered to be an indication for aggressive endovascular treatment prior to spinal surgery.

　　Delays in diagnosis and treatment may lead to a fatal result in cases of traumatic tracheal injury, and those typically caused by the result of blunt thoracic injury. We encountered a case of tracheal injury caused by a bullhorn, which is extremely rare in Japan, successfully treated with non-operative management on a remote, medically underserved island without transport to a tertiary healthcare institution. A 31-year-old male had a tracheal injury in the middle of the cervical region, and increasing subcutaneous emphysema was observed. Both sedation and the use of appropriate antibiotics successfully led to the patient’s recovery.

　　We present a rare case of delayed pseudoaneurysm formation in the proper hepatic artery without hepatic injury following blunt trauma. The patient was a 42-year-old man who was injured by a fall from height. Initial computed tomography (CT) showed no hepatic injury, but vascular wall irregularity was noted from the origin of the proper hepatic artery to left hepatic artery, and a small hematoma was observed in the hepatoduodenal ligament. Follow-up CT conducted three days post-injury showed no pseudoaneurysms in the hepatic arteries. However, pseudoaneurysms in the proper hepatic artery and left hepatic artery were incidentally confirmed by CT at two months post-injury. The patient was treated immediately with coil embolization, and his postoperative course was uneventful. Extrahepatic vascular injury should be considered when initial abdominal CT shows hematoma in the hepatoduodenal ligament and vascular wall irregularity.

　　A 85-year-old man with a history of a thyroid tumor was brought to our hospital after falling from a height. On arrival, he had inspiratory stridor and neck swelling, so we judged the presence of an airway emergency and performed tracheal intubation. Based on imaging findings and the medical history, we diagnosed him with thyroid tumor rupture. Due to cervical hematoma expansion and airway narrowing, we judged that surgery was indicated, and performed hematoma removal, left lobe thyroidectomy, and tracheotomy. He was weaned from mechanical ventilation on the second hospital day, and discharged independently on the 28th hospital day. Traumatic thyroid injury caused by blunt cervical injury is rare, but it can be fatal. Surgery can be performed to remove a hematoma as well as for hemostasis, but thyroidectomy may be required for bleeding from a tumor. If airway stenosis persists after surgery, tracheotomy can be performed for early weaning from ventilation and rehabilitation.