Table 3. Subjects with non-Biffl criteria cervical spine fracture with blunt cerebrovascular injuries.
| Age (y) | Sex | Mechanism of injury | Cervical spine fracture | Blunt cerebrovascular injury | Biffl grade | Treatment |
|---|---|---|---|---|---|---|
| 27.3 | M | Fall | Left C5 inferior articular facet and lamina fractures with associated fractures of the left superior articular facet of C6 and T1 | Left vertebral artery dissection with thrombus resulting in occlusion of the left vertebral artery from thoracic inlet to C2 level | 4 | Heparin drip to aspirin |
| 55.8 | M | MVC | Left C5 inferior articular facet and left C6 superior articular facet fractures | Bilateral vertebral artery narrowing focally at the C5 level bilaterally without evidence of occlusion | 2 | Heparin drip to clopidogrel |
| 29.6 | M | MCC | Right C5 lateral mass fracture | Left proximal vertebral artery high-grade narrowing likely on the basis of dissection along the C5–C7 levels | 2 | Heparin drip to aspirin |
| 50.9 | M | Fall | Right C6 lamina fracture with extension into right facet joint | Right vertebral artery narrowing of 25% narrowing at the C4–C5 level | 1 | Heparin drip to nothing on discharge |
| 34.9a | M | MCC | Left C6 and C7 transverse process fractures | Left internal carotid artery focal dissection at the C1 level without high-grade stenosis and long-segment luminal irregularity of the right internal carotid artery without high-grade stenosis | 2 | None secondary to intracranial hemorrhage |
| 36.2 | M | MVC | Left C6 nondisplaced lamina fracture with extension into facet joint | Left vertebral artery luminal irregularity at level of C6 level | 1 | Clopidogrel |
| 78.8 | M | Fall | Right C7 lamina fracture with extension into articular facet and C6 anterior listhesis | Right vertebral artery dissection with less than 25% narrowing at C6–C7 level | 1 | Heparin drip to aspirin |
| 59.2 | M | MVC | Left C6 and C7 nondisplaced transverse processes fractures | Left vertebral artery occlusion just distal to origin of artery | 4 | Aspirin |
Abbreviations: MCC, motorcycle collision; MVC, motor vehicle collision.
a
Only non-Biffl criteria cervical spine fracture that met screening criteria based on other factors for midface fractures.