Bleeding from Penetrating Vertebral Artery Injury: A Difficult Injury to Control

This is a case of a male who suffered a penetrating injury to the neck with difficult to control bleeding. He was transferred from an outside hospital and was hypotensive on admission. He was on multiple vasopressors and attempts were made to control bleeding in the emergency room. He showed minimal signs of neurologic function. He was taken to the angiography suite where a left vertebral artery injury was identified with significant extravasation. Angiographic embolization was attempted with mitigation of the bleeding but without complete resolution of bleeding extravasation. The patient was delivered to the surgical intensive care unit where he was noted to be unchanged neurologically. The patient expired shortly thereafter.