Emergency Cases Northwest Group
016 Pain in the neck
Situation
A 90 year old lady hurt her neck and had a serious neurological injury
despite no fracture
Background
She fell flat on her face. Neck injury. Odd and fleeting numbness and
weakness all limbs, worst in legs. CT neck and CTA showed no fracture.
MRI neck: extensive cord oedema. Treated conservatively: collar and
neuro-rehab.
Assessment
Treated as central cord syndrome by specialists; although classically
that syndrome affects the arms more than legs.
Recommendation
Central cord syndrome usually occurs in the elderly due to pre-existing
retrolithiasis and osteophytes.
Caused by hyperextension injury of neck, usually injury to forehead also.
Suspect it if the patient has even vague and confusing limb neurology
as in this case [important to know that CT can be normal and need to do
MRI].
PLEASE DO NOT INCLUDE ANY PATIENT IDENTIFIABLE DATA OR
GEO-LOCATION DATA IN THE SUBMISSION OR IN ANY ATTACHED
IMAGES
Emergency Cases Northwest Group