Traumatic Cervical Nerve Root Avulsion with Pseudomeningocele Formation (original) (raw)
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Post-traumatic cervical pseudomeningocele: A case report
International Journal of Case Reports and Images, 2020
Introduction: The traumatic lesions of the brachial plexus mainly are due to stretching, tearing, bruising, or direct sores accentuated by a hematoma or the presence of a foreign body. Stretching of the brachial plexus can lead to avulsion and/or pseudomeningocele. Case Report: It is a case of a 12-year-old child who was admitted to the emergency room after a public road accident for the management of an open arm fracture, for which he received stabilization by screw plate fixation. Evolution was marked with anesthesia in the area of the musculocutaneous nerve. Magnetic resonance imaging (MRI) showed a left C7 pseudomeningocele with root avulsion. The patient underwent surgery but unfortunately did not recover his neurological deficit. Late electroneuromyography (ENMG) showed distal nerve damages which can explain the failure of surgery. Conclusion: If MRI distinguishes a preganglionic lesion from proximal postganglionic involvement, it ignores distal lesions. Electroneuromyography and MRI are therefore complementary in the determination of the reversibility or not of lesions of the brachial plexus and in the choice of the most appropriate treatment.
Post-Traumatic Brachial Plexus Root Avulsion: A Case Report
EAS journal of radiology and imaging technology, 2023
Root avulsion corresponds to the tearing of the roots of the spinal cord by stretching during a trauma. The most incriminated etiologies are road accidents and obstetric trauma. It results clinically in total or partial paralysis of the limb concerned or neuropathic pain. MRI is the key diagnostic test. Here we report a case of post-traumatic brachial plexus root avulsion in a 61-year-old patient following a road accident. The MRI of the cervical plexus, performed one month after the trauma, revealed a pre-foraminal fluid-like lesion on the left next to the D1 conjugation hole, suggestive of a pseudomeningocele. MRI is the key diagnostic imaging tool. In fact, it establishes the lesion topography, whether pre or post-nodal, and enables the search for associated lesions.
Journal of Neurosurgery: Spine, 2002
Object. The authors describe a new magnetic resonance (MR) imaging technique to demonstrate the status of the cervical nerve roots involved in brachial plexus injury. They discuss the accuracy and reproducibility of a MR imaging—derived classification for diagnosis of nerve root avulsion compared with those of myelography combined with computerized tomography (CT) myelography. Methods. The overlapping coronal—oblique slice MR imaging procedure was performed in 35 patients with traumatic brachial plexus injury and 10 healthy individuals. The results were retrospectively evaluated and classified into four major categories (normal rootlet, rootlet injuries, avulsion, and meningocele) after confirming the diagnosis by surgical exploration with or without spinal evoked potential (EP) measurements and by referring to myelography and CT myelography findings. The reliability and reproducibility of the MR imaging—based classification was prospectively assessed by eight independent observers,...
Traumatic Spinal Cord Injuries Due to Motor Vehicle Accidents
2018
Background and Aim: Spine trauma is an important health problem. Traumatic Spinal Cord Injury (SCI) due to Motor Vehicle Accident (MVA) might have a different epidemiologic pattern in Guilan province of Iran owing to its geographical characteristics. Therefore, the present study was conducted to the study epidemiology of SCI injuries due to road accidents in a trauma referral center in Guilan. Methods and Materials/Patients: In this cross-sectional study, we used data SCI registry of Poursina Hospital. All the patients with spine trauma, due to MVA, hospitalized in the trauma center of Poursina Hospital, Rasht, Guilan, Iran between March 2015 and March 2018 were studied. Results: A total of 127 patients with spine trauma due to MVA were reviewed. The Mean±SD age of patients was 38.27±16.22 years. We observed that 93.7%, 1.6%, and 4.7% of the patients had initial Glasgow Comma Scale (GCS ≥13, 9 ≤GCS ≤12, and GCS<9, respectively). SCIs were found several anatomical regions including cervical (n=54, 42.5%), lumbar (n=39, 30.7%), thoracic (n=23, 18.1%), thoracic and lumbar (n=7, 5.5%), thoracic and cervical (n=3, 2.4%), and lumbar and cervical (n=1, 0.8%) regions. Evaluated by Glasgow Outcome Scale (GOS), good recovery, moderate disability, severe disability, vegetative state, and death were found in 114(91.2%), 4 (3.1%), 4(3.1%), 1(0.8%), 2(1.6%) of the patients, respectively. Two patients were discharged by their personal contest. Conclusion: Spine trauma due to MVA is mostly seen in the young. SCI due to such trauma is mostly found in the cervical region. Good recovery was seen in most of the subjects.
Cervical Spine Injuries Most Commonly Occur in Traffic Accidents
The spine is made up of vertebrae, ring-shaped bones that line up in a row to form the spinal canal. Inside the spinal canal is the spinal cord-a bundle of nerve fibers and cells that conduct nerve impulses from the brain to various parts of the body and vice versa. The individual nerves that exit the spinal canal are separated from the spinal cord. In vertebral fractures, bone fragments can injure the spinal cord, leading to partial or complete muscle loss and loss of sensation below the level of the injury. The spinal cord can be damaged at the very moment of the vertebral injury, but also later when moving and carrying the injured person. Injuries occur when direct physical force damages the vertebrae, ligaments or discs of the spine, causing crushing, crushing or rupture of brain tissue, and penetrating brain injuries. Such injuries can also lead to vascular damage leading to ischemia or hematoma causing additional damage. All types of injuries can cause brain edema which further reduces blood flow and oxygenation.
Transient Quadriplegia: A Case-Based Approach to Cervical Trauma
Clinical Practice and Cases in Emergency Medicine, 2021
Introduction Spinal cord injuries are a common reason for presentation to the emergency department (ED). Sports-related spinal injuries are one of the least common spinal injuries, falling behind vehicular accidents, acts of violence, and falls. Case Report This case report describes a case of transient quadriplegia in a 17-year-old male who presented to the ED after a helmet-to-helmet collision while participating in football. Conclusion Emergency physicians should be cognizant of potential spinal cord injury using clinical decision tools and radiologic imaging to properly disposition a patient presenting with cervical spine injury.