Vertebral Artery Injury Associated with a Jefferson Fracture

     Gregory S Walsh and Michael D Cusimano

Abstract:   Background: The evaluation and treatment of Jefferson fractures, a burst fracture of the ring of C1, has been well documented in the medical literature. Vertebral artery injury associated with a Jefferson fracture is very rare. Methods: The case study technique was used to summarize the case. Review of the literature was performed to discuss the case. Retrospective chart review of the 174 patients with cervical fractures admitted to St. Michael's Hospital from 1989-1994 was also performed. Results: The case of a patient with a Jefferson fracture, with bilateral lateral displacement of the lateral masses causing bilateral vertebral artery occlusions resulting in a lateral medullary and cerebellar infarction is reported. A review of the literature is provided. Conclusion: A high index of suspicion for this injury is paramount, especially in patients with multiple trauma, where the diagnosis of Jefferson fractures can be delayed.

Can. J. Neurol. Sci. 1995; 22: 308-311