Traumatic Cervical Nerve Root Avulsion with Pseudomeningocele Formation

Area of Science:

• Neurology
• Traumatology
• Radiology

Background:

• Cervical nerve root avulsion is a known consequence of high-velocity motor vehicle collisions (MVCs).
• These injuries can involve meningeal tears, cerebrospinal fluid (CSF) collection, and pseudomeningocele formation.

Observation:

• A 19-year-old male presented with right arm paralysis post-MVC.
• Neurological exam revealed intact sensation but 0/5 muscle strength in the right upper extremity.
• MRI showed extensive cervical epidural hematomas and C3-C7 anterior horn cell edema with traumatic nerve root avulsions (C5-C8) and pseudomeningoceles.

Findings:

• The case presents a rare instance of spinal cord hematoma accompanying multiple-level nerve root avulsions.
• Massive epidural hematomas extended from C2 caudally.
• Associated findings included pseudomeningoceles from C5-C8 on the right.

Implications:

• This case highlights a rare and severe presentation of cervical nerve root injury following MVC.
• Conservative management was initiated for the brachial plexus injury.
• Further research into diagnostic criteria, treatment, and complications of such injuries is warranted.