Traumatic cervical distraction complicated by delayed reduction due to traumatic vertebral artery pseudo-aneurysm

A 23-year-old male involved in a high-speed collision acquired, among other injuries, a wide fracture distraction at C2/C3. Reduction was delayed by an enlarging vertebral artery pseudo-aneurysm at the site of injury which was successfully treated by proximal endovascular occlusion with a detachable polymer-filled balloon. A traumatic arachnoid cyst or pseudomeningocele was also demonstrated at the injury site but intervention was not required. The treatment and outcome of these three uncommon injuries in the literature is reviewed and discussed. Given the severity of the injury, the absence of severe long-term neurological disability is notable.