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Radiology.Academy.Sk

CTA C-Spine Verts

Procedure: CTA of the neck.

Technique: Post IV contrast thin section transverse images through the neck during the arterial phase of contrast enhancement. Images were reformatted in coronal and sagittal planes. Axial, coronal and sagittal MIP reformats for also obtained.

Comparison: CT of the cervical spine performed 30 minutes prior.

Findings: There is posterior fusion hardware construct with lateral mass screws spanning the C1-C3 vertebral segments with adjoining vertical rods. There is transection of the left vertebral artery at the level of C2 secondary to fusion hardware screw. There is reconstitution of flow at the level of the occipital condyles. Posterior pedicle screw is seen immediately adjacent to the right vertebral artery. However there is normal enhancement and caliber throughout the entire length of the right vertebral artery. Aortic arch and proximal brachiocephalic arteries are normal. Right and left common and internal carotid demonstrates normal flow. The patient is intubated. Dependent atelectasis is noted. Lung apices are clear. Unchanged post operative changes.

IMPRESSION:
1. Transection of the left vertebral artery at the level of C2 with reconstitution of flow at the level of the occipital condyles.
2. Right C2 screw immediately adjacent to the right vertebral artery. However normal flow and enhancement is seen throughout the length of the right vertebral artery.