Related Experiment Video
Updated: May 28, 2026
A Contusive Model of Unilateral Cervical Spinal Cord Injury Using the Infinite Horizon Impactor
Published on: July 24, 2012
[Injuries to the upper cervical medulla in severe brain injuries]
D Woischneck1, T Kapapa, C Grimm
1Neurochirurgie, Klinikum Landshut. dieter.woischneck@klinikum-landshut.de
Background:
Cranial magnetic resonance imaging (MRI) was performed in 250 patients who had been unconscious post-trauma for at least 24 hours. The frequency and the characteristics of injuries to the upper cervical myelon were determined.
Patients And Methods:
Between 1996 and 2009, MRI was carried out within 8 days of trauma.
Results:
No lesions of the upper cervical medulla were found without accompanying damage to the medulla oblongata. Two groups were found to have a lesion in the upper cervical myelon. (i) In 3.2 % of the patients in a state of deep coma MRI revealed lesions in the entire brain stem. These died without waking from coma. (ii) 2 % of the patients were found to have additional damage to the distal medulla oblongata. These victims of high-speed traumas awoke from coma after 2-3 days. They revealed frontal contusions of the brain and traumatic subarachnoidal hemorrhages. Injuries to the bony upper cervical spine and/or the skull base were frequent. Four of them died, one patient survived with severe disabilities.
Conclusion:
Two types of lesions involving the upper cervical myelon could be differentiated, both of which occur only in association with lesions in the medulla oblongata.
Insights
Injuries to the upper cervical spinal cord were identified in unconscious trauma patients using magnetic resonance imaging (MRI). These lesions consistently occurred with damage to the brainstem, specifically the medulla oblongata.
Area of Science:
- Neurology
- Radiology
- Trauma Surgery
Context:
- Cranial magnetic resonance imaging (MRI) is crucial for evaluating patients with prolonged unconsciousness post-trauma.
- Understanding the specific patterns of upper cervical myelon injuries is vital for prognosis and treatment.
Purpose:
- To determine the frequency and characteristics of upper cervical myelon injuries in patients unconscious for at least 24 hours post-trauma.
- To investigate the association between upper cervical myelon lesions and damage to the medulla oblongata.
Summary:
- MRI scans of 250 unconscious trauma patients revealed that upper cervical myelon lesions never occurred in isolation.
- Two distinct injury patterns were identified: 3.2% with brainstem lesions (fatal coma) and 2% with additional medulla oblongata damage (survivors with varied outcomes).
- Associated injuries included frontal contusions, subarachnoid hemorrhages, and bony cervical spine/skull base trauma.
Impact:
- This study differentiates two types of upper cervical myelon lesions, both linked to medulla oblongata damage.
- Findings highlight the critical relationship between brainstem and upper cervical spinal cord integrity in severe trauma.
- Results aid in predicting outcomes and guiding clinical management for severe traumatic brain and spinal cord injuries.
Related Concept Videos
01:25Secondary Spinal Cord Injury llI: Pathophysiology
01:26Arteries of the Head and Neck
The internal carotid arteries supply blood to the anterior portion of the cerebrum. They enter the...
01:14Spinal Cord Injury ll: Pathophysiology
01:29Increased Intracranial Pressure ll: Pathophysiology
01:28Traumatic Brain Injury l: Introduction
01:19Brainstem
The Midbrain
The midbrain is located beneath the diencephalon and connects the cerebrum with the lower parts of the brain. The cerebral peduncles are prominent midbrain structures that house the...