{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T22:29:52Z","timestamp":1769725792124,"version":"3.49.0"},"reference-count":38,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"8","license":[{"start":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T00:00:00Z","timestamp":1756080000000},"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":[[2025,8,25]]},"abstract":"\n BACKGROUND<\/jats:title>\n When treating a penetrating vertebral artery (VA) injury, blindly removing a foreign object that has pierced the artery can lead to distal embolism due to thrombus formation at the penetration site and uncontrollable hemorrhage during foreign object removal.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n A 68-year-old man was impaled in the posterior neck by a 7-cm metal rod during brush cutting. Neither neurological deficits nor active bleeding was observed. CT revealed that the metal rod had penetrated between the left C1 and C2 transverse foramina, and CT angiography showed occlusion at the V2 segment of the left VA. Retrograde distal embolization via a contralateral approach was performed, followed by proximal embolization to achieve complete occlusion before rod removal. No arterial bleeding occurred during rod removal. Postoperative MRI revealed a small infarct in the left cerebellum, but no neurological deficits were present.<\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n In cases of penetrating VA injury with a retained foreign object, vascular evaluation and embolization should be considered before foreign object removal. Retrograde distal embolization via a contralateral approach, combined with proximal embolization, may be an effective strategy for preventing distal embolism and controlling hemorrhage.<\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE25435<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case25435","type":"journal-article","created":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T23:49:22Z","timestamp":1756770562000},"source":"Crossref","is-referenced-by-count":0,"title":["Distal and proximal embolization for penetrating vertebral artery injury: illustrative case"],"prefix":"10.3171","volume":"10","author":[{"given":"Natsuki","family":"Akaike","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Kurashiki Central Hospital, Kurashiki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5710-7456","authenticated-orcid":true,"given":"Hiroyuki","family":"Ikeda","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kurashiki Central Hospital, Kurashiki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haruki","family":"Yamashita","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kurashiki Central Hospital, Kurashiki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minami","family":"Uezato","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kurashiki Central Hospital, Kurashiki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masanori","family":"Kinosada","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kurashiki Central Hospital, Kurashiki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0738-760X","authenticated-orcid":true,"given":"Yoshitaka","family":"Kurosaki","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kurashiki Central Hospital, Kurashiki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaki","family":"Chin","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kurashiki Central Hospital, Kurashiki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"bib1","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":"6","key":"bib2","series-title":"J Trauma","first-page":"1171","article-title":"Guglielmi detachable coils embolization of a penetrating vertebral artery injury: a case report","volume":"55","author":"Ahn","year":"2003","unstructured":"Ahn JYKim OJSong WSLee BHJoo JY.Guglielmi detachable coils embolization of a penetrating vertebral artery injury: a case report. J Trauma. 2003;55(6):1171-1174."},{"issue":"15","key":"bib3","series-title":"Spine (Phila Pa 1976)","first-page":"E931","article-title":"Stab wound with lodged knife tip causing spinal cord and vertebral artery injuries: case report and literature review","volume":"37","author":"Xia","year":"2012","unstructured":"Xia XZhang FLu FJiang JWang LMa X.Stab wound with lodged knife tip causing spinal cord and vertebral artery injuries: case report and literature review. Spine (Phila Pa 1976). 2012;37(15):E931-E934."},{"issue":"4","key":"bib4","series-title":"Korean J Spine","first-page":"258","article-title":"Vertebral artery dissect injury with Brown-S\u00e9quard syndrome by a neural foramen penetrated electric screw driver bit: a case report","volume":"10","author":"Oh","year":"2013","unstructured":"Oh CHKim MSNoh SHShin DAJi GY.Vertebral artery dissect injury with Brown-S\u00e9quard syndrome by a neural foramen penetrated electric screw driver bit: a case report. Korean J Spine. 2013;10(4):258-260."},{"key":"bib5","series-title":"Surg Neurol Int","article-title":"Strategy for endovascular coil embolization of a penetrating vertebral artery injury","volume":"6","author":"Uchikawa","year":"2015","unstructured":"Uchikawa HKai YOhmori YKuratsu JI.Strategy for endovascular coil embolization of a penetrating vertebral artery injury. Surg Neurol Int. 2015;6:117."},{"key":"bib6","series-title":"Ann Vasc Surg","first-page":"267.e1","article-title":"Endovascular treatment of penetrating injury to the vertebral artery by a stab wound: case report and literature review","volume":"45","author":"Leiderman","year":"2017","unstructured":"Leiderman DBDZerati AEWolosker NHoffmann Melo HAda Silva ESDe Luccia N.Endovascular treatment of penetrating injury to the vertebral artery by a stab wound: case report and literature review. Ann Vasc Surg. 2017;45:267.e1-267.e5."},{"issue":"1","key":"bib7","series-title":"Acute Med Surg","first-page":"83","article-title":"Treatment strategy for a penetrating stab wound to the vertebral artery: a case report","volume":"6","author":"Yaguchi","year":"2019","unstructured":"Yaguchi SYamamura HKamata KShimamura NKakehata SMatsubara A.Treatment strategy for a penetrating stab wound to the vertebral artery: a case report. 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J Trauma. 1995;39(3):480-484."},{"issue":"2","key":"bib17","series-title":"Eur J Vasc Endovasc Surg","first-page":"157","article-title":"Management of extra-cranial vertebral artery injuries","volume":"27","author":"Mwipatayi","year":"2004","unstructured":"Mwipatayi BPJeffery PBeningfield SJMotale PTunnicliffe JNavsaria PH.Management of extra-cranial vertebral artery injuries. Eur J Vasc Endovasc Surg. 2004;27(2):157-162."},{"issue":"5","key":"bib18","series-title":"Emerg Radiol","first-page":"291","article-title":"Embolization of transected vertebral arteries in unstable trauma patients","volume":"11","author":"Atar","year":"2005","unstructured":"Atar EGriton IBachar GNBartal GKluger YBelenky A.Embolization of transected vertebral arteries in unstable trauma patients. 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