Neslihan Yücel1, Cem Ertan2, Mustafa S Pepele1, Ahmet Sigirci3. 1. Inonu University Faculty of Medicine, Department of Emergency Medicine, Malatya, Turkey. 2. Izmir University Faculty of Medicine, Department of Emergency Medicine, Izmir, Turkey. 3. Inonu University Faculty of Medicine, Department of Radiology, Malatya, Turkey.
Abstract
BACKGROUND: Traumatic central cord syndrome (TCCS) is the most frequently encountered incomplete spinal cord injury, and it is a relatively rare situation in children younger than 15 years, but may have serious consequences. METHODS: We report the case of a 2-year-old female child with upper extremity weakness following a simple fall. All vitals and systemic examination findings were normal, except for 2/5 muscular strength in the upper extremities. While radiographic imaging showed no pathologic findings, MRI exposed spinal injury. The patient was treated conservatively with medication only. The medical treatment of the patient consisted of anti-edema treatment with methylprednisolone in the first 24 hours; 330 mg of methylprednisolone infused in the first hour, followed by 59 mg per hour during the next 23 hours. Along with pharmacological treatment, she received physiotherapy sessions during her 11-day hospitalization period. RESULTS: The child had full recovery within 6 months after conservative treatment. CONCLUSION: Neurological deficit without plain radiographic evidence in pediatric spinal trauma patients is a rare but significant incident.
BACKGROUND:Traumatic central cord syndrome (TCCS) is the most frequently encountered incomplete spinal cord injury, and it is a relatively rare situation in children younger than 15 years, but may have serious consequences. METHODS: We report the case of a 2-year-old female child with upper extremity weakness following a simple fall. All vitals and systemic examination findings were normal, except for 2/5 muscular strength in the upper extremities. While radiographic imaging showed no pathologic findings, MRI exposed spinal injury. The patient was treated conservatively with medication only. The medical treatment of the patient consisted of anti-edema treatment with methylprednisolone in the first 24 hours; 330 mg of methylprednisolone infused in the first hour, followed by 59 mg per hour during the next 23 hours. Along with pharmacological treatment, she received physiotherapy sessions during her 11-day hospitalization period. RESULTS: The child had full recovery within 6 months after conservative treatment. CONCLUSION:Neurological deficit without plain radiographic evidence in pediatric spinal traumapatients is a rare but significant incident.
Authors: Marcus Hofbauer; Manuela Jaindl; Leonard Lee Höchtl; Roman C Ostermann; R Kdolsky; Silke Aldrian Journal: J Trauma Acute Care Surg Date: 2012-07 Impact factor: 3.313