PICA injury secondary to anterior odontoid screw fixation: Case report of an exceptional complication - 31/05/21
, M. Meyer a, A. Reyre b, K. Cot c, S. Fuentes aBienvenue sur EM-consulte, la référence des professionnels de santé.
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Abstract |
Background |
Odontoid fracture is a common injury in the upper cervical spine that can sometimes be managed by anterior odontoid screw fixation.
Case description |
We report the first case of iatrogenic postero-inferior cerebellar artery (PICA) injury while performing anterior odontoid screw fixation for a type II odontoid fracture in a 22-year-old man. Fisher grade 4 subarachnoid hemorrhage secondary to iatrogenic pseudoaneurysm formation was managed by the endovascular neuroradiologist. Odontoid fracture was then managed posteriorly using Harm's technique. Postoperative 12-month follow-up revealed good clinical and radiological results. CT scan showed fusion. Complete exclusion of the pseudo aneurysm with a mild stroke in the inferior left cerebellar hemisphere were noted on the MRI. There were no cerebellar ataxia or swallowing disorders.
Conclusion |
To the best of our knowledge, this is the first case report of iatrogenic PICA injury in anterior odontoid screw fixation. The patient was well managed in our institution within a multidisciplinary team. We recommend that surgical management of odontoid fractures should be performed in expert centres.
Le texte complet de cet article est disponible en PDF.Keywords : Odontoid fracture, Complication, Anterior fixation, Iatrogenic, PICA injury, Pseudoaneurysm
Plan
| ☆ | This paper has not been presented (nor published) previously. |
Vol 67 - N° 4
P. 310-314 - juillet 2021 Retour au numéro
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