Isolated temporal infarct due traumatic vertebral artery dissecting pseudo-aneurysm: a rare case report

The authors describe a rare case of traumatic vertebral artery dissecting pseudo-aneurysm with temporal lobe infarct in the pre-foramina segment of the left vertebral artery following knife injury of the left anterolateral neck area. A 40 years old man was admitted to the emergency department after a penetrating injury in the left anterolateral neck. On contrast-enhanced CT and Doppler ultrasonography in the neck, a dissecting pseudo-aneurysm of the vertebral artery was revealed.On day 2, MRI scanning revealed an ischemic infarct in the temporal lobe, which can be attributed to vertebral artery injury. The case was treated conservatively and the patient was discharged on the fourth hospital day. Owing to the position of the artery, traumatic vertebral artery dissections are uncommon, and they are linked with a high mortality rate due to aneurismal rupture and embolic impact of the dissections, culminating in stroke in young people. Our findings demonstrate the necessity of imaging in head and neck traumatic injuries to detect vertebral artery injuries far sooner in order to prevent complications.