Parent artery occlusion for cerebral infarction after spontaneous recanalization in traumatic vertebral artery: A case report

Surgical Neurology International, 2023 · DOI: 10.25259/SNI_462_2023 · Published: August 4, 2023

Simple Explanation

A 49-year-old man experienced a traumatic vertebral artery occlusion after a traffic accident, which initially resolved with medication. However, he later developed a cerebral infarction. To prevent further complications, doctors performed a parent artery occlusion. The patient's vertebral artery spontaneously reopened, but later a thrombus formed, leading to a stroke. The doctors then decided to block the parent artery to prevent the thrombus from causing further damage. The procedure of parent artery occlusion stopped any further strokes from happening, and the patient was able to go home with only minor lasting effects, showing that this method can be helpful in similar cases.

Study Duration

Not specified

Participants

A 49-year-old man

Evidence Level

Case Report

Key Findings

1
Spontaneous recanalization of a traumatic vertebral artery occlusion without an occlusive mechanism may carry a similar risk of cerebral infarction as mechanically occluded arteries after repair surgery.
2
Parent artery occlusion can be considered to prevent recanalization and subsequent thrombus scattering, even when repair surgery isn't required.
3
Early diagnosis and prophylactic treatment are important for traumatic vertebral artery injury.

Research Summary

The case report describes a 49-year-old man who experienced a traumatic vertebral artery occlusion following a traffic accident. The occlusion spontaneously recanalized under conservative treatment, but the patient later developed a cerebral infarction. Parent artery occlusion was performed to prevent further cerebral infarction due to distal embolization of the thrombus. The patient was discharged with a modified Rankin scale score of 1. The authors conclude that in cases of traumatic vertebral artery occlusion without an occlusive mechanism, parent artery occlusion should be considered based on recanalization risk, regardless of the need for repair surgery.

Practical Implications

Treatment Strategy

Parent artery occlusion should be considered in cases of traumatic vertebral artery occlusion without an occlusive mechanism.

Risk Assessment

Recanalization risk should be assessed when deciding on parent artery occlusion, regardless of the need for repair surgery.

Further Research

Further case accumulation is needed to achieve appropriate patient selection for parent artery occlusion.

Study Limitations

1
The limited evidence base for establishing treatment guidelines due to the variability in pathophysiology.
2
Uncertainty regarding which patients will spontaneously recanalize.
3
The study is a single case report, limiting the generalizability of the findings.

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