Vascular complications of upper cervical spine injuries.

Upper cervical spine injuries can be complicated by occlusion of the vertebral and carotid arteries. Injury to the former is more common. The arteries may be kinked or temporarily occluded, in which case the symptoms are transient. With more forceful trauma, damage to the intima and subsequent thrombosis or prolonged spasm may ensue. Early recognition of ischemic symptoms hastens the diagnosis. In most instances it is not possible to alter advanced neurologic deficits once they are established.