Vertebral Artery Trauma

Despite its protected path within the body, trauma to the vertebral artery is not infrequently encountered in the practice of forensic pathology.

The vertebral arteries may be injured from penetrating trauma or severe blunt force trauma. However, it is injury from lesser blunt force trauma that often is of most forensic relevance. Due to the protected anatomical course, the investigation and documentation of dissection, rupture and other pathological conditions of the vertebral arteries can be challenging. Methods of examination include radiology with and without angiography, and specialised dissections techniques that allow direct visualisation of the arteries and subsequent sampling for histological assessment. Suspicion of a vertebral artery injury may arise from the circumstances of death, radiological investigation prior to autopsy, or during the autopsy examination. A considered approach and meticulous autopsy examination is required to optimise the likelihood of identifying the site of injury, however despite such efforts the site of injury sometimes remains undetermined. The mechanisms of injury are also poorly understood. The circumstances surrounding these deaths are often such that they are of considerable forensic interest and scrutiny. Identification of the injury site, along with histological examination, can clarify the potential forensic issues.