Acute Basilar Artery Occlusion and Death Secondary to Bilateral Vertebral Artery Dissection.

Vertebral artery dissection as a cause of basilar artery thrombosis is an exceedingly rare event that is associated with significant morbidity and poor outcomes. We present an unusual case of bilateral vertebral artery dissection and spinal cord compression in a 21-year-old male involved in a diving accident. The patient received limited antithrombotic therapy in pursuit of surgical spinal decompression, ultimately contributing to thrombosis of the basilar artery in the post-operative period and death following anterior cervical discectomy and fusion.

Review of massive transfusion protocols in the injured, bleeding patient.

Purpose Of Review: Massive haemorrhage is a significant cause of mortality and morbidity in a variety of clinical settings, although most research has been related to trauma patients. Military studies from recent conflicts found that higher ratios of plasma to red blood cells (RBCs) were associated with increased survival in injured soldiers, and subsequent trials in civilian populations showed similar decreased mortality. Over the last decade, massive transfusion protocols (MTPs) have become an important component in the treatment of the massively bleeding patient.