Pontomedullary infarction from sustained cervical spine hyperflexion

• Published in: Surgical neurology Vol. 26; no. 3; pp. 282 - 286
• Main Authors: Faillace, Walter J., Okawara, Shige-Hisa
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.09.1986; Elsevier
• Subjects: Adult; Biological and medical sciences; Brain - blood supply; Brainstem; Cerebral infarction; Cerebral Infarction - diagnostic imaging; Cerebral Infarction - etiology; Cerebral Infarction - physiopathology; Humans; Male; Medical sciences; Medulla Oblongata; Neurology; Pons; Pontomedullary; Radiography; Spinal cord hyperflexion; Spinal Cord Injuries - complications; Spinal Cord Injuries - diagnostic imaging; Vascular diseases and vascular malformations of the nervous system; Vertebral Artery - physiopathology; Vertebrobasilar insufficiency; Cerebral infarction; Spinal cord hyperflexion; Pontomedullary; Vertebrobasilar insufficiency; Brainstem; Human; Bending; Nervous system diseases; Brain stem infarction; Cervical spine; Cerebrovascular disease
• ISSN: 0090-3019; 1879-3339
• DOI: 10.1016/0090-3019(86)90163-1

A paraplegic but independent 26-year-old man developed pontomedullary infarction from a fall which placed him in a position of sustained cervical spine hyperflexion. An early noncontrast computed tomography scan displayed infarction of the pontomedullary region. The patient made partial recovery of his neurologic deficits. The infarct was thought to arise from compromise of blood flow through the vertebrobasilar vessels during hyperflexion of the cervical spine. The mechanisms that impeded blood flow in the vertebrobasilar territory and the prognostic factors of ischemic infarction in this area are discussed.