A case of real spinal cord injury without radiologic abnormality in a pediatric patient with spinal cord concussion

Abstract

The present case study, in which MRI was performed, showed that an immediate improvement was obtained in a patient who experienced real SCIWORA. The importance of not only spinal cord lesions, but also perispinal soft tissue injury on MRI has been emphasized for predicting patient outcomes. Accordingly, immediate MRI is essential for evaluating patients with signs and symptoms of spinal cord injury, even when plain neck roentgenography and cervical CT are negative.

Clinical diagnosis and treatment of spinal cord injury without evidence of abnormality in children: a review

“…The patients who underwent early and appropriate management showed an improvement in their neurological symptoms, which enhanced the probability of neurological recovery and reduced complications. 2,5,7,8,13,16,24 MVAs are the most common causes of injury, followed by falls, sports, and other mechanisms (abuse, minor trauma, sudden onset). An excess of sports injuries occurred in adolescents, whereas MVA-related injuries were more common in toddlers.…”

“…However, performing an MRI on admission or within the first seven hours of injury can help in early diagnosis. [4][5][6][7][8] T1 and T2-weighted MRIs of the spinal cord differentiate white from grey matter and identify macroscopic anatomical changes within the cord in a diseased or injured area. In pediatrics, various treatment methods have poor effects on SCIWORA; some authors advocate treating patients with immobilization and corticosteroid therapy followed by rehabilitation.…”

Pediatric SCIWORA-Type Injuries Revisited: What Should be the Most Discerning Definition of SCIWORA at the Current Days?

“…Since the negative impact of Central Nervous System (CNS) injuries on somatic growth in children is well established [24], even mild neurological sequelae suffered at a young age will have repercussions on orthopaedic development in the medium to long term [25], especially progressive neuromuscular scoliosis [26]. Second, the possibility of the development of intraspinal tissue damage resulting from the development of gliosis and/or syringomyelia [27] leading to unexpected and unexplained long-term neurological impairment, even in the case of only transient or mild initial neurological signs and symptoms have been addressed both among pediatric [28,29] and adult population [30]. Syringomyelia is recognized as the main factor of neurological deterioration following SCI, since MRI has improved the diagnosis, but the correlation between the severity of SCI and the incidence of Post-Traumatic Syringomyelia (PTS) or the time interval to its onset is controversial [30].…”