{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T10:27:19Z","timestamp":1770114439520,"version":"3.49.0"},"reference-count":46,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"16","license":[{"start":{"date-parts":[[2025,4,21]],"date-time":"2025-04-21T00:00:00Z","timestamp":1745193600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2025,4,21]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Vertebral artery injury (VAI) is a rare but serious condition, with an incidence of 0.24%\u20132% following blunt trauma and 1%\u20136% after penetrating injuries. Often asymptomatic, VAI carries significant risks, including ischemic strokes and severe neurological deficits, with symptoms appearing up to 6 months postinjury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 64-year-old man experienced a critical neck injury from rebar penetration, resulting in hemorrhagic shock. Imaging revealed a left C3\u20134 fracture, vertebral artery (VA) transection, pseudoaneurysm, and arteriovenous fistula. Coil embolization was attempted but failed, necessitating stent placement and balloon dilation to restore VA patency. Postprocedure MRI revealed an epidural hematoma without spinal cord involvement. Surgical decompression and fixation were performed the next day, followed by dual antiplatelet therapy. The patient was discharged on day 13 without neurological deficits, and in-stent stenosis was successfully treated with balloon dilation 1 year later.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>This case highlights the successful treatment of a Denver scale grade V transected VAI using stent placement, emphasizing the importance of VA reconstruction as the primary treatment goal.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE24557\">https:\/\/thejns.org\/doi\/10.3171\/CASE24557<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case24557","type":"journal-article","created":{"date-parts":[[2025,4,21]],"date-time":"2025-04-21T20:10:26Z","timestamp":1745266226000},"source":"Crossref","is-referenced-by-count":0,"title":["Traumatic vertebral artery transection injury: illustrative case"],"prefix":"10.3171","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6199-9204","authenticated-orcid":true,"given":"Chien-Tung","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, China Medical University Hospital, Taichung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei-Liang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Interventional and Diagnostic Neuroradiology, China Medical University Hospital, Taichung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying-Lin","family":"Tseng","sequence":"additional","affiliation":[{"name":"Department of Interventional and Diagnostic Neuroradiology, China Medical University Hospital, Taichung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheng-Di","family":"Chiu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, China Medical University Hospital, Taichung, Taiwan"},{"name":"Graduate Institute of Biomedical Science, China Medical University, Taichung, Taiwan"},{"name":"Spine Center, China Medical University Hospital, Taichung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chun-Chung","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, China Medical University Hospital, Taichung, Taiwan"},{"name":"Stroke Center, China Medical University Hospital, Taichung, Taiwan"},{"name":"Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6429-3565","authenticated-orcid":true,"given":"Der-Yang","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, China Medical University Hospital, Taichung, Taiwan"},{"name":"Graduate Institute of Biomedical Science, China Medical University, Taichung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chun-Chieh","family":"Liang","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, Taichung Armed Forces General Hospital, Taichung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeng-Hung","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, China Medical University Hospital, Taichung, Taiwan"},{"name":"Spine Center, China Medical University Hospital, Taichung, Taiwan"},{"name":"Stroke Center, China Medical University Hospital, Taichung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"3","key":"bib1","series-title":"J Vasc Surg","first-page":"741","article-title":"Contemporary outcomes of vertebral artery injury","volume":"57","author":"Alterman","year":"2013","unstructured":"Alterman DMHeidel REDaley BJContemporary outcomes of vertebral artery injury. J Vasc Surg. 2013;57(3):741-746."},{"issue":"2","key":"bib2","series-title":"J Trauma","first-page":"279","article-title":"Blunt cerebrovascular injuries: diagnosis and treatment","volume":"51","author":"Miller","year":"2001","unstructured":"Miller PRFabian TCBee TKBlunt cerebrovascular injuries: diagnosis and treatment. J Trauma. 2001;51(2):279-286."},{"issue":"4","key":"bib3","series-title":"J Spinal Disord Tech","first-page":"252","article-title":"Vertebral artery injuries associated with cervical spine injuries: a review of the literature","volume":"21","author":"Fassett","year":"2008","unstructured":"Fassett DRDailey ATVaccaro AR.Vertebral artery injuries associated with cervical spine injuries: a review of the literature. J Spinal Disord Tech. 2008;21(4):252-258."},{"issue":"6","key":"bib4","series-title":"J Trauma","first-page":"1150","article-title":"Western Trauma Association critical decisions in trauma: screening for and treatment of blunt cerebrovascular injuries","volume":"67","author":"Biffl","year":"2009","unstructured":"Biffl WLCothren CCMoore EEWestern Trauma Association critical decisions in trauma: screening for and treatment of blunt cerebrovascular injuries. J Trauma. 2009;67(6):1150-1153."},{"issue":"5","key":"bib5","series-title":"Ann Surg","first-page":"672","article-title":"The devastating potential of blunt vertebral arterial injuries","volume":"231","author":"Biffl","year":"2000","unstructured":"Biffl WLMoore EEElliott JPThe devastating potential of blunt vertebral arterial injuries. Ann Surg. 2000;231(5):672-681."},{"issue":"5","key":"bib6","series-title":"J Trauma","first-page":"811","article-title":"Cervical spine fracture patterns predictive of blunt vertebral artery injury","volume":"55","author":"Cothren","year":"2003","unstructured":"Cothren CCMoore EEBiffl WLCervical spine fracture patterns predictive of blunt vertebral artery injury. J Trauma. 2003;55(5):811-813."},{"issue":"9","key":"bib7","series-title":"Eur Spine J","first-page":"1405","article-title":"Blunt traumatic vertebral artery injury: a clinical review","volume":"20","author":"Desouza","year":"2011","unstructured":"Desouza RMCrocker MJHaliasos NRennie ASaxena A.Blunt traumatic vertebral artery injury: a clinical review. 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J Trauma Acute Care Surg. 2013;74(3):818-824."},{"issue":"5","key":"bib16","series-title":"Ann Surg","first-page":"699","article-title":"Treatment-related outcomes from blunt cerebrovascular injuries: importance of routine follow-up arteriography","volume":"235","author":"Biffl","year":"2002","unstructured":"Biffl WLRay CEJrMoore EETreatment-related outcomes from blunt cerebrovascular injuries: importance of routine follow-up arteriography. Ann Surg. 2002;235(5):699-707."},{"issue":"5","key":"bib17","series-title":"Neurosurg Focus","first-page":"E16","article-title":"A comparison of digital subtraction angiography and computed tomography angiography for the diagnosis of penetrating cerebrovascular injury","volume":"47","author":"Ares","year":"2019","unstructured":"Ares WJJankowitz BTTonetti DAGross BAGrandhi R.A comparison of digital subtraction angiography and computed tomography angiography for the diagnosis of penetrating cerebrovascular injury. Neurosurg Focus. 2019;47(5):E16."},{"issue":"15","key":"bib18","series-title":"J Neurosurg Case Lessons","first-page":"CASE2392","article-title":"Acute traumatic dural arteriovenous fistula of the superior sagittal sinus: illustrative case","volume":"5","author":"Pryce","year":"2023","unstructured":"Pryce MLChung KHCZeineddine HADawes BH.Acute traumatic dural arteriovenous fistula of the superior sagittal sinus: illustrative case. J Neurosurg Case Lessons. 2023;5(15):CASE2392."},{"issue":"4","key":"bib19","series-title":"J Neurosurg","first-page":"447","article-title":"Consequence of ligation of the vertebral artery","volume":"36","author":"Shintani","year":"1972","unstructured":"Shintani AZervas NT.Consequence of ligation of the vertebral artery. J Neurosurg. 1972;36(4):447-450."},{"issue":"5","key":"bib20","series-title":"Stroke","first-page":"1363","article-title":"Vertebral artery hypoplasia: frequency and effect on cerebellar blood flow characteristics","volume":"45","author":"Thierfelder","year":"2014","unstructured":"Thierfelder KMBaumann ABSommer WHVertebral artery hypoplasia: frequency and effect on cerebellar blood flow characteristics. Stroke. 2014;45(5):1363-1368."},{"issue":"9","key":"bib21","series-title":"J Neurol Neurosurg Psychiatry","first-page":"954","article-title":"Hypoplastic vertebral artery: frequency and associations with ischaemic stroke territory","volume":"78","author":"Park","year":"2007","unstructured":"Park JHKim JMRoh JK.Hypoplastic vertebral artery: frequency and associations with ischaemic stroke territory. J Neurol Neurosurg Psychiatry. 2007;78(9):954-958."},{"issue":"1","key":"bib22","series-title":"Interv Neuroradiol","first-page":"42","article-title":"Metal coverage ratio of pipeline embolization device for treatment of unruptured aneurysms: reality check","volume":"22","author":"Jou","year":"2016","unstructured":"Jou LDChintalapani GMawad ME.Metal coverage ratio of pipeline embolization device for treatment of unruptured aneurysms: reality check. Interv Neuroradiol. 2016;22(1):42-48."},{"issue":"4","key":"bib23","series-title":"Neuroradiology","first-page":"369","article-title":"Pipeline embolization device (PED) for neurovascular reconstruction: initial experience in the treatment of 101 intracranial aneurysms and dissections","volume":"54","author":"Fischer","year":"2012","unstructured":"Fischer SVajda ZAguilar Perez MPipeline embolization device (PED) for neurovascular reconstruction: initial experience in the treatment of 101 intracranial aneurysms and dissections. Neuroradiology. 2012;54(4):369-382."},{"issue":"3","key":"bib1","series-title":"J Vasc Surg","first-page":"741","article-title":"Contemporary outcomes of vertebral artery injury","volume":"57","author":"Alterman","year":"2013","unstructured":"Alterman DMHeidel REDaley BJContemporary outcomes of vertebral artery injury. J Vasc Surg. 2013;57(3):741-746."},{"issue":"2","key":"bib2","series-title":"J Trauma","first-page":"279","article-title":"Blunt cerebrovascular injuries: diagnosis and treatment","volume":"51","author":"Miller","year":"2001","unstructured":"Miller PRFabian TCBee TKBlunt cerebrovascular injuries: diagnosis and treatment. J Trauma. 2001;51(2):279-286."},{"issue":"4","key":"bib3","series-title":"J Spinal Disord Tech","first-page":"252","article-title":"Vertebral artery injuries associated with cervical spine injuries: a review of the literature","volume":"21","author":"Fassett","year":"2008","unstructured":"Fassett DRDailey ATVaccaro AR.Vertebral artery injuries associated with cervical spine injuries: a review of the literature. J Spinal Disord Tech. 2008;21(4):252-258."},{"issue":"6","key":"bib4","series-title":"J Trauma","first-page":"1150","article-title":"Western Trauma Association critical decisions in trauma: screening for and treatment of blunt cerebrovascular injuries","volume":"67","author":"Biffl","year":"2009","unstructured":"Biffl WLCothren CCMoore EEWestern Trauma Association critical decisions in trauma: screening for and treatment of blunt cerebrovascular injuries. J Trauma. 2009;67(6):1150-1153."},{"issue":"5","key":"bib5","series-title":"Ann Surg","first-page":"672","article-title":"The devastating potential of blunt vertebral arterial injuries","volume":"231","author":"Biffl","year":"2000","unstructured":"Biffl WLMoore EEElliott JPThe devastating potential of blunt vertebral arterial injuries. Ann Surg. 2000;231(5):672-681."},{"issue":"5","key":"bib6","series-title":"J Trauma","first-page":"811","article-title":"Cervical spine fracture patterns predictive of blunt vertebral artery injury","volume":"55","author":"Cothren","year":"2003","unstructured":"Cothren CCMoore EEBiffl WLCervical spine fracture patterns predictive of blunt vertebral artery injury. J Trauma. 2003;55(5):811-813."},{"issue":"9","key":"bib7","series-title":"Eur Spine J","first-page":"1405","article-title":"Blunt traumatic vertebral artery injury: a clinical review","volume":"20","author":"Desouza","year":"2011","unstructured":"Desouza RMCrocker MJHaliasos NRennie ASaxena A.Blunt traumatic vertebral artery injury: a clinical review. Eur Spine J. 2011;20(9):1405-1416."},{"issue":"5","key":"bib8","series-title":"Can J Neurol Sci","first-page":"662","article-title":"Work-up and management of asymptomatic extracranial traumatic vertebral artery injury","volume":"50","author":"Maclean","year":"2023","unstructured":"Maclean MATouchette CJDuda TWork-up and management of asymptomatic extracranial traumatic vertebral artery injury. Can J Neurol Sci. 2023;50(5):662-672."},{"issue":"16","key":"bib9","series-title":"Spine","first-page":"1352","article-title":"Vertebral artery injury associated with blunt cervical spine trauma: a multivariate regression analysis","volume":"38","author":"Lebl","year":"2013","unstructured":"Lebl DRBono CMVelmahos GMetkar UNguyen JHarris MB.Vertebral artery injury associated with blunt cervical spine trauma: a multivariate regression analysis. Spine. 2013;38(16):1352-1361."},{"issue":"suppl 2","key":"bib10","series-title":"Neurosurgery","first-page":"234","article-title":"Management of vertebral artery injuries following non-penetrating cervical trauma","volume":"72","author":"Harrigan","year":"2013","unstructured":"Harrigan MRHadley MNDhall SSManagement of vertebral artery injuries following non-penetrating cervical trauma. Neurosurgery. 2013;72(suppl 2):234-243."},{"issue":"6","key":"bib11","series-title":"J Vasc Surg","first-page":"2161","article-title":"A systematic review of penetrating extracranial vertebral artery injuries","volume":"71","author":"Asensio","year":"2020","unstructured":"Asensio JADabestani PJWenzl FAA systematic review of penetrating extracranial vertebral artery injuries. J Vasc Surg. 2020;71(6):2161-2169."},{"key":"bib12","series-title":"World Neurosurg","first-page":"e518","article-title":"Penetrating vertebral artery injuries: a literature review and proposed treatment algorithm","volume":"148","author":"Piper","year":"2021","unstructured":"Piper KRabil MCiesla DPenetrating vertebral artery injuries: a literature review and proposed treatment algorithm. World Neurosurg. 2021;148:e518-e526."},{"issue":"8","key":"bib13","series-title":"AJNR Am J Neuroradiol","first-page":"1585","article-title":"Endovascular treatment of traumatic injuries of the vertebral artery","volume":"29","author":"Herrera","year":"2008","unstructured":"Herrera DAVargas SADublin AB.Endovascular treatment of traumatic injuries of the vertebral artery. AJNR Am J Neuroradiol. 2008;29(8):1585-1589."},{"issue":"3","key":"bib14","series-title":"J Trauma","first-page":"E78","article-title":"Penetrating vertebral artery pseudoaneurysm: a novel endovascular stent graft treatment with artery preservation","volume":"67","author":"Khoie","year":"2009","unstructured":"Khoie BKuhls DAAgrawal RFildes JJ.Penetrating vertebral artery pseudoaneurysm: a novel endovascular stent graft treatment with artery preservation. J Trauma. 2009;67(3):E78-E81."},{"issue":"3","key":"bib15","series-title":"J Trauma Acute Care Surg","first-page":"818","article-title":"Contemporary management of combat-related vertebral artery injuries","volume":"74","author":"Greer","year":"2013","unstructured":"Greer LTKuehn RBGillespie DLContemporary management of combat-related vertebral artery injuries. J Trauma Acute Care Surg. 2013;74(3):818-824."},{"issue":"5","key":"bib16","series-title":"Ann Surg","first-page":"699","article-title":"Treatment-related outcomes from blunt cerebrovascular injuries: importance of routine follow-up arteriography","volume":"235","author":"Biffl","year":"2002","unstructured":"Biffl WLRay CEJrMoore EETreatment-related outcomes from blunt cerebrovascular injuries: importance of routine follow-up arteriography. Ann Surg. 2002;235(5):699-707."},{"issue":"5","key":"bib17","series-title":"Neurosurg Focus","first-page":"E16","article-title":"A comparison of digital subtraction angiography and computed tomography angiography for the diagnosis of penetrating cerebrovascular injury","volume":"47","author":"Ares","year":"2019","unstructured":"Ares WJJankowitz BTTonetti DAGross BAGrandhi R.A comparison of digital subtraction angiography and computed tomography angiography for the diagnosis of penetrating cerebrovascular injury. Neurosurg Focus. 2019;47(5):E16."},{"issue":"15","key":"bib18","series-title":"J Neurosurg Case Lessons","first-page":"CASE2392","article-title":"Acute traumatic dural arteriovenous fistula of the superior sagittal sinus: illustrative case","volume":"5","author":"Pryce","year":"2023","unstructured":"Pryce MLChung KHCZeineddine HADawes BH.Acute traumatic dural arteriovenous fistula of the superior sagittal sinus: illustrative case. J Neurosurg Case Lessons. 2023;5(15):CASE2392."},{"issue":"4","key":"bib19","series-title":"J Neurosurg","first-page":"447","article-title":"Consequence of ligation of the vertebral artery","volume":"36","author":"Shintani","year":"1972","unstructured":"Shintani AZervas NT.Consequence of ligation of the vertebral artery. J Neurosurg. 1972;36(4):447-450."},{"issue":"5","key":"bib20","series-title":"Stroke","first-page":"1363","article-title":"Vertebral artery hypoplasia: frequency and effect on cerebellar blood flow characteristics","volume":"45","author":"Thierfelder","year":"2014","unstructured":"Thierfelder KMBaumann ABSommer WHVertebral artery hypoplasia: frequency and effect on cerebellar blood flow characteristics. Stroke. 2014;45(5):1363-1368."},{"issue":"9","key":"bib21","series-title":"J Neurol Neurosurg Psychiatry","first-page":"954","article-title":"Hypoplastic vertebral artery: frequency and associations with ischaemic stroke territory","volume":"78","author":"Park","year":"2007","unstructured":"Park JHKim JMRoh JK.Hypoplastic vertebral artery: frequency and associations with ischaemic stroke territory. J Neurol Neurosurg Psychiatry. 2007;78(9):954-958."},{"issue":"1","key":"bib22","series-title":"Interv Neuroradiol","first-page":"42","article-title":"Metal coverage ratio of pipeline embolization device for treatment of unruptured aneurysms: reality check","volume":"22","author":"Jou","year":"2016","unstructured":"Jou LDChintalapani GMawad ME.Metal coverage ratio of pipeline embolization device for treatment of unruptured aneurysms: reality check. 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