頸椎骨折に合併した外傷性両側椎骨動脈閉塞の1症例

Traumatic Occlusion of the Bilateral Vertebral Arteries Associated with Fracture of the Cervical Spine: A case report

I．はじめに

　頸部の血管外傷のうちで椎骨動脈損傷は少ないながらも存在する．損傷部位は，その特殊な解剖学的走行と頸部の伸展，屈曲や回転といった運動に関連して主に第5,6頸椎やatlanto-axial joint，atlanto-occipital jointで起こり，muralhemorrhageやintimal disruptionが生ずることが知られている^12）．Rich andSpencer^10）は統計的に7048例の血管外傷中15例で椎骨動脈損傷があることを，また，Flintら^4）は1957-73年に経験した全頸部血管外傷中，約3％の7例に椎骨動脈外傷が見られたことを報告している．

　われわれは，第6頸椎の圧迫骨折に合併した外傷性両側椎骨動脈閉塞の症例を経験した．

A case of traumatic occlusion of the bilateral verte-bral arteries associated with fracture of the cervical spine is reported.

A 34-year-old man, having no previously noted medical problems, fell to the bottom of a bathtub with a depth of 80 cm, and hit the vertex fronto-parietal re-gion of his head. He was transfered to our hospital 6 hours after his fall with a crush fracture of the cervical spine at the C₆ level. On admission he was alert, but having pain in the vertex region, dysarthria, blurred vi-sion and hemiparesis. Roentgenograms confirmed a crush fracture of the C₆ vertebral body.