Stroke due to vertebral artery injury.

Minimal neck injury produced vertebral artery damage in two women and three men, 20 to 57 years of age. Serious neurologic deterioration occurred in two patients when positioned for roentgenographic procedures. Dissection or thrombosis of one or both vertebral arteries while in the transverse foramina occurred in three, one at the site of an osteophyte. The arteriogram of one patient showed a traumatic aneurysm at C-7, and a second patient had segmental arterial stenosis with bilateral traumatic aneurysms at C-5. The location of the arterial injury is not restricted to the occipitoatlantoaxial level but includes the course through the transverse foramina. The use of anticoagulation appears to be important in the immediate management of this process.