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Ultrasound can detect alternating vertebral artery occlusions due to hangman fracture
Author(s) -
Ohara Keiichiro,
Sato Takeo,
Mitsumura Hidetaka,
Arai Ayumi,
Komatsu Teppei,
Sakai Kenichiro,
Kawamura Daichi,
Ohashi Hiroki,
Ishibashi Toshihiro,
Murayama Yuichi,
Iguchi Yasuyuki
Publication year - 2020
Publication title -
neurology and clinical neuroscience
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.125
0ISSN - 2049-4173
DOI - 10.1111/ncn3.12381
Subject(s) - medicine , vertebral artery , radiology , magnetic resonance imaging , transcranial doppler , angiography , magnetic resonance angiography , computed tomography angiography
We present a case of alternating vertebral artery occlusions due to hangman fracture which was detected by repeated ultrasound. An 89‐year‐old woman presented with sudden onset of consciousness disturbance. Magnetic resonance imaging showed bilateral cerebellar ischemic lesions and daily alternating vertebral artery occlusions. Carotid ultrasonography and transcranial color flow imaging showed blood flow changes from day to day which indicated an abnormal hemodynamic status of bilateral vertebral artery. Computed tomography angiography revealed hangman fracture and severe compression of bilateral vertebral artery with thrombi. We applied Halo‐Vest fixation and started the patient on anticoagulation therapy. Then, carotid ultrasonography and transcranial color flow imaging demonstrated improvement of bilateral vertebral artery blood flow. The patient remained free of neurological deficits after Halo‐Vest fixation and anticoagulation. This case highlights the importance of repeated ultrasonographic evaluation of cerebral arteries in patients with ischemic stroke by hangman fracture.