Vertebral artery dissection revisited

Aggrawal, Anil; Setia, Pardaman Singh

doi:10.1136/jcp.2005.030742

Cited by 3 publications

(4 citation statements)

References 5 publications

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“…On the other hand, more suitable methods are those that allow immediate vertebral artery examination. These methods, such as the present procedure, remove the vertebral arteries during head–neck autopsy by opening the transversarium foramen (vertebroarterial canal) (7,11,12). Nevertheless, our method differs from those previously published in the way that vertebroarterial canal is dissected by posterior (rather than anterior) approach, being the neck dissection both quicker and easier comparatively with the anterior approach (10,13).…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, our method differs from those previously published in the way that vertebroarterial canal is dissected by posterior (rather than anterior) approach, being the neck dissection both quicker and easier comparatively with the anterior approach (10,13). Improvements to the procedures already published are related to the fact that the proposed posterior approach allows a very optimal exposition of the transverse part (segment V3) of the vertebral artery, a critical segment for the traumatic injuries that remain unobserved during the anterior neck approach (11,12,14). Additionally, given that our procedure approaches the vertebroarterial canal through spinal canal, it improves the neuropathological study.…”

Section: Discussionmentioning

confidence: 99%

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A Proposed Dissection Procedure for Vertebral Arteries in Forensic Pathology

Galtés¹,

Rodríguez‐Baeza

Subirana³

et al. 2011

Journal of Forensic Sciences

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Vertebral artery removing constitutes a significant forensic pathology challenge. Dissection techniques during head-neck autopsy are based on anterior approach, a difficult method, which is unable to assess the transverse part of the artery. This work presents an original and simple method for dissecting vertebral arteries by a posterior approach, opening the vertebroarterial canal through the spinal canal without any special equipment. Once the spinal cord is removed, the transversarium foramens are opened by an internal cut at the pedicle and an external cut at the transverse process. This enables us to visualize vertebral arteries in its entirety. The method improves both the examination of the upper extracranial segment of the vertebral artery and the neuropathological study when arterial injury is suspected. Applying this method routinely is both feasible and useful in suspected cases of vertebral artery trauma and could contribute to assess more precisely the actual incidence of this injury.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Proposed Dissection Procedure for Vertebral Arteries in Forensic Pathology

Galtés¹,

Rodríguez‐Baeza

Subirana³

et al. 2011

Journal of Forensic Sciences

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“…At present, comprehensive examinations including specialised imaging and dissection techniques for TBSH is recommended but are not performed routinely (22,23) . The examination methods employed in our cases were varied.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…Most but not all of the cases underwent comprehensive examinations consisting of brain and cervical spine retention as well as radiographic imaging. A survey of the literature revealed many proposed protocols all including a combination of angiography, en-bloc neck dissection, and careful brain dissection and removal (4,6,8,9,22) .…”

Section: Accepted Manuscriptmentioning

confidence: 99%

The source of haemorrhage in traumatic basal subarachnoid haemorrhage

Wong

Ong

Milne

2015

Journal of Forensic and Legal Medicine

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Vertebral Artery Dissection Complicating Occipital Injection of Heparin for Treatment of Thoracic Outlet Syndrome

Melinek

Hart

2012

American Journal of Forensic Medicine &Amp; Pathology

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A 38-year-old woman with a 2-year history of chronic neck pain radiating down her right arm underwent radiological and neurological evaluations, which revealed no anatomical cause for her pain. She sought alternative therapies including intramuscular heparin injections. Following a right occipital injection of heparin, cyanocobalamin, and lidocaine, she had a sudden cardiorespiratory arrest and was successfully resuscitated, but did not regain consciousness.Computed tomography of the head and neck and subsequent autopsy revealed a right vertebral artery dissection, but at autopsy, no significant subarachnoid hemorrhage was noted at the base of the brain. This is the first case report where heparin (a potent anticoagulant) used in an occipital injection was documented to cause a vertebral artery dissection. It is also the first reported case where radiographically and histologically documented vertebral artery dissection did not present with overwhelming subarachnoid hemorrhage at the base of the brain. The subtle gross anatomical findings in this case highlight the importance of evaluating the cervical spinal cord in any case of sudden cardiorespiratory arrest following even apparently minor neck injury.

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Vertebral artery dissection revisited

Cited by 3 publications

References 5 publications

A Proposed Dissection Procedure for Vertebral Arteries in Forensic Pathology

A Proposed Dissection Procedure for Vertebral Arteries in Forensic Pathology

The source of haemorrhage in traumatic basal subarachnoid haemorrhage

Vertebral Artery Dissection Complicating Occipital Injection of Heparin for Treatment of Thoracic Outlet Syndrome

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