Vertebral artery insufficiency in acute and chronic spinal trauma, with special reference to the syndrome of acute central cervical spinal cord injury.

Abstract

OR many years surgeons have been puzzled by the fact that some patients with injuries of the cervical spine have sustained severe neurological deficit without alteration in the alignment of the bony spine. This neurological disability frequently has followed a definite pattern which was described several years ago as the acute central cervical spinal cord injury syndrome. It was thought that this syndrome resulted from a certain type of cervical cord contusion. However, careful neurological evaluation of subsequent eases has suggested that this syndrome also may be caused by a second mechanism, namely, one of partial or relative insu:fieieney of the vertebral artery to the cervical spinal cord. In this paper 4 cases are presented to demonstrate the mechanisms involved and to support the evolution of these concepts. CONTUSION In 1948 Taylor and Blackwood -s discussed