# Massive Hemorrhage Associated With Upper Cervical Vertebral Fracture Treated Successfully With Transcatheter Arterial Embolization: A Case Report

## TL;DR

A rare case of severe bleeding from a vertebral artery branch injury was successfully treated with a minimally invasive procedure.

## Contribution

This case report highlights successful treatment of a rare and severe vertebral artery injury using transcatheter embolization.

## Key findings

- Transcatheter arterial embolization successfully controlled massive hemorrhage from a vertebral artery branch injury.
- Superselective embolization preserved the main vertebral artery trunk while treating the bleeding branch.
- The case emphasizes the importance of recognizing branch vessel injuries in upper cervical spine fractures.

## Abstract

Blunt vertebral artery injuries (BVAI) associated with cervical spine fractures are often problematic due to symptoms of occlusion. Denver grade V cases, in which the vertebral artery is transected, are rare but often fatal, and treatment has rarely been reported. We encountered a case of hemorrhagic shock due to an injury to a branch of the vertebral artery associated with an upper cervical spine fracture. Transcatheter arterial embolization was performed successfully to achieve hemostasis, requiring superselective arterial embolization to preserve the main trunk of the vertebral artery. It is important to be aware that vascular injuries to the branch vessels as well as the main trunk can cause complications.