تقرير
Traumatic pneumocephalus as a possible early sign of acute spinal cord injury: Case report.
العنوان: | Traumatic pneumocephalus as a possible early sign of acute spinal cord injury: Case report. |
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المؤلفون: | Patel MS; Department of Neurosurgery, Saint Louis University, 1008 S. Spring Ave, 3rd Floor, Saint Louis, MO, United States., Patel NK; Department of Neurosurgery, Saint Louis University, 1008 S. Spring Ave, 3rd Floor, Saint Louis, MO, United States., Alexopoulos G; Department of Neurosurgery, Saint Louis University, 1008 S. Spring Ave, 3rd Floor, Saint Louis, MO, United States., Mercier P; Department of Neurosurgery, Saint Louis University, 1008 S. Spring Ave, 3rd Floor, Saint Louis, MO, United States., Mattei TA; Department of Neurosurgery, Saint Louis University, 1008 S. Spring Ave, 3rd Floor, Saint Louis, MO, United States. |
المصدر: | North American Spine Society journal [N Am Spine Soc J] 2023 Sep 27; Vol. 16, pp. 100281. Date of Electronic Publication: 2023 Sep 27 (Print Publication: 2023). |
نوع المنشور: | Case Reports |
اللغة: | English |
بيانات الدورية: | Publisher: Elsevier Inc Country of Publication: United States NLM ID: 9918335076906676 Publication Model: eCollection Cited Medium: Internet ISSN: 2666-5484 (Electronic) Linking ISSN: 26665484 NLM ISO Abbreviation: N Am Spine Soc J Subsets: PubMed not MEDLINE |
أسماء مطبوعة: | Original Publication: [New York] : Elsevier Inc., [2020]- |
مستخلص: | Background: Traumatic pneumocephalus (TPC) following craniofacial injuries is common, but isolated TPC secondary to pneumorrhachis (PR) is the rare result of upward gas migration from the spinal canal. In the absence of craniofacial and grossly unstable spinal fractures, the etiology of TPC in polytrauma can be elusive and an underlying diagnosis of acute spinal cord injury (SCI) can be easily missed. We report the first polytrauma case where TPC was the most reliable early sign of SCI. Case Description: A 34-year-old polytrauma female with imaging findings of TPC, which was later found to be secondary to an underlying SCI. As a focused exam could not be performed at admission, the TPC was first attributed to undiagnosed craniofacial injuries. Tertiary survey revealed the patient being paraplegic and MRI workup demonstrated an acute SCI at the T3-T4 level. PR was the most likely cause of TPC in the absence of other craniofacial injuries. Outcome: The patient did not have a meaningful recovery given the extensive hemispheric infarcts, spinal cord injury, and respiratory failure. Conclusions: Although uncommon, TPC may be an important radiographic sign suggesting the possibility of an underlying SCI in polytrauma patients. especially when focused neurologic assessment is limited at admission. Polytrauma patients with TPC and PR in the absence of coexisting craniofacial fractures require an urgent spine consultation by the ER physician, with possible early spine MRI workup. We suggest a diagnostic algorithm for the early identification of SCI in polytrauma patients presenting with TPC and propose considering 3 groups which may have different risks for SCI based on their clinical presentation and the presence of PR. Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (© 2023 The Author(s).) |
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فهرسة مساهمة: | Keywords: Emergency; Pneumocephalus; Pneumorrhachis; Polytrauma; Spinal cord injury; Spine |
تواريخ الأحداث: | Date Created: 20231109 Latest Revision: 20231110 |
رمز التحديث: | 20231110 |
مُعرف محوري في PubMed: | PMC10628802 |
DOI: | 10.1016/j.xnsj.2023.100281 |
PMID: | 37942311 |
قاعدة البيانات: | MEDLINE |
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