An interesting case report of vertebral artery dissection following polytrauma

• Routine/regular screening is not undertaken in polytrauma patients.
• Vertebral artery dissection can be clinically challenging to detect and diagnose due to its diverse presentation and the lack of uniform screening/guidelines.
• The pathological process is more common in polytrauma and therefore there needs to be a high index of suspicion in this group of patients.
• CT angiogram and/or Doppler and duplex ultrasonography should be used as a non-invasive screening tool in patients with significant traumatic injuries.
• Early anticoagulation should ideally be the treatment, however, in traumatic injuries it is seldom used.

IntroductionThe authors present an interesting case of a 19-year-old male who presented as a polytrauma patient following a fall from a height.Presentation of caseHe was initially managed on the intensive care unit with intracranial pressure bolt monitoring after being intubated and sedated and having his other traumatic injuries stabilized. Upon attempting to wean sedation and extubation a repeat CT scan of the head was undertaken and showed a new area suggested of cerebral infarction, this was a new finding. Further imaging found that he had a cervical vertebral artery dissection following this polytrauma mode of injury.DiscussionThe incidence of vertebral artery dissection following generalized or local trauma is rising but routine imaging/screening in these patients is not undertaken.ConclusionOur report displays select images related to this case report and emphasizes the consideration of routine imaging in head and neck traumatic injuries to diagnose internal carotid and/or vertebral artery dissections much earlier.