Traumatic cervical vertebral artery aneurysm associated with suicidal stabs

BACKGROUND: Cervical vertebral artery (VA) aneurysm occasionally develops in association with penetrating injury. However, its treatment strategy is not yet determined. CASE DESCRIPTION: A 50-year-old woman with bipolar disorder attempted suicide by stabbing herself in the lateral neck. At presentation, focal neurological deficits were not observed. Spinal computed tomography (CT) showed unclear delineation of the VA in the right C4/5 intervertebral foramen. CT performed 7 days later identified an aneurysm of the right VA at C4/5, with abnormal arteriovenous shunts between the aneurysm and paravertebral venous plexus. The patient underwent coil embolization of the VA segment involving the aneurysm on the same day that was complicated by cerebellar ataxia due to procedure-associated infarction. CONCLUSION: Traumatic VA aneurysms associated with penetrating injuries should be carefully managed with a detailed presurgical evaluation of the relevant cranial and spinal structures.