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[Thoracic spinal cord avulsion without radiologic abnormalities: case report].

Asdrubal Falavigna1, Marcelo Mattana, Alisson Roberto Teles

  • 1Universidade de Caxias do Sul, Rua Colonel Arcy da Rocha Nóbrega 401/602, 95040-290 Caxias do Sul, RS, Brazil. asdrubal@doctor.com

Arquivos De Neuro-Psiquiatria
|October 24, 2006
PubMed
Summary

Spinal cord injury without radiologic abnormalities (SCIWRA) is rare in children. This case highlights complete spinal cord transection despite normal initial imaging, emphasizing the need for advanced diagnostics.

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Area of Science:

  • Pediatric neurology
  • Traumatic spinal cord injury
  • Pediatric neurosurgery

Background:

  • Spinal cord injury without radiologic abnormalities (SCIWRA) is an uncommon diagnosis, predominantly affecting pediatric populations.
  • This condition is associated with significant morbidity in affected children.

Observation:

  • A five-month-old infant sustained a spinal cord injury following an automobile accident.
  • The infant presented with sensory deficits at T2 and bilateral lower extremity paralysis (paraplegia).
  • Initial radiographic and CT scans revealed no bone or ligamentous injuries.

Findings:

  • Magnetic resonance imaging (MRI) demonstrated a complete spinal cord transection.
  • Spinal avulsion was identified between the T3 and T7 vertebral segments.

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  • These findings indicate severe spinal cord damage not apparent on conventional imaging.

    • Implications:

    • SCIWRA necessitates advanced imaging like MRI for accurate diagnosis, even with negative initial radiographic evaluations.
    • Early and precise diagnosis is crucial for appropriate management and prognostic assessment in pediatric SCI.
    • This case underscores the importance of considering severe spinal cord injury in pediatric trauma patients presenting with neurological deficits, irrespective of initial imaging results.