Transverse foramen fractures in cervical spine can cause injury to vertebral artery. It can occur as a result of occlusion, laceration, or distractive avulsion of the artery.
The incidence of vertebral artery injury following lower cervical spine trauma has been reported to be as high as 46%.
Transverse foramen fractures have been associated with facet dislocations, facet fractures with translation, and transverse foramen fractures .
Majority of injuries are unilateral.
Diagnosis
Detection of the injury can has important influences on overall decision making.
An xray would raise the suspicion of transverse foramen fracture. MR arteriograms are an effective means of noninvasive diagnosis of vertebral artery occlusion or narrowing following cervical trauma.
Arteriography is another option.
Bilateral vertebral artery injuries can be devastating, leading to cerebellar infarction.
Treatment
The vast majority of injuries are unilateral, which have a very low rate of clinical sequelae. In most cases, no specific treatment is necessary.
However, the presence of arterial injury does affect the treatment decision of the fracture.
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