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