Vertebral Artery Injury: Case Report and Review of Operative Approaches

Traumatic injury to the upper third of the neck, cephalad to the angle of the mandible, distorts the complexity of normal anatomy and underscores the importance of preoperative arteriography when possible. This report describes the case of a young man who was brought to the Emergency Room of our hospital suffering from a severe gunshot wound to the cervical spine, vertebral artery, and maxillofacial skeleton. His injury was successfully managed by combining a standard arterolateral incision with a procedure that has been described for exposing retro maxillary tumors. This operative technique provided the surgeon with direct access to the injury, controlled the loss of blood, and permitted repair of accompanying pharyngeal and facial injuries. Our report also reviews the technical considerations and pertinent surgical anatomy of this rare combination of Injuries