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Traumatic central cord syndrome in a 2-year-old child: minor trauma but major complication
Neslihan Yücel1, Cem Ertan2, Mustafa S Pepele1
1Inonu University Faculty of Medicine, Department of Emergency Medicine, Malatya, Turkey.
Insights
Traumatic central cord syndrome (TCCS) in children is rare but serious. A 2-year-old fully recovered with conservative treatment, highlighting the importance of early diagnosis and management for pediatric spinal cord injuries.
Area of Science:
- Pediatric neurology
- Spinal cord injury research
- Traumatology
Background:
- Traumatic central cord syndrome (TCCS) is the most common incomplete spinal cord injury.
- TCCS is rare in children under 15 but can have severe consequences.
- Pediatric spinal trauma may present with neurological deficits despite normal radiographic findings.
Observation:
- A 2-year-old female presented with upper extremity weakness after a fall.
- Physical examination revealed 2/5 muscular strength in upper extremities; systemic findings were normal.
- MRI confirmed spinal injury, though initial radiographs were unremarkable.
Findings:
- The child received conservative management, including methylprednisolone and physiotherapy.
- Full neurological recovery was achieved within 6 months of treatment.
- Conservative treatment proved effective for this pediatric TCCS case.
Implications:
- This case underscores the significance of neurological deficits in pediatric spinal trauma, even without clear radiographic evidence.
- Early diagnosis and conservative management can lead to favorable outcomes in pediatric TCCS.
- Highlights the need for advanced imaging like MRI in evaluating pediatric spinal trauma.
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.
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