Adult spinal cord injury without radiological abnormality

Crawford, Sarah M.; Bleetman, Tony

doi:10.1136/emj.17.5.374

Cited by 5 publications

(1 citation statement)

References 5 publications

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“…When there is a likely diagnosis based on clinical findings and CT scan results, methylprednisolone may be administered before definitive radiological imaging by MRI [16]. The administration of a bolus dose of methylprednisolone (30 mg/kg) within three hours of injury, followed by a continuous infusion of methylprednisolone at a rate of 5.4 mg/kg per hour for 24 hours, or an alternative regimen involving a bolus dose within eight hours of injury followed by a 48-hour infusion, has been associated with significantly improved neurological outcomes [17].…”

Section: Discussionmentioning

confidence: 99%

Inpatient Multidisciplinary Rehabilitation in Adult Spinal Cord Injury Without Neuroimaging Abnormality (SCIWNA): A Case Report

Neto,

Ribeiro,

Guimaraes

et al. 2024

Cureus

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Spinal cord injury without radiographic abnormality is a condition primarily observed in the pediatric population. However, its occurrence in adults remains underreported. This case report aims to describe a rare instance of adult spinal cord injury without neuroimaging abnormality (SCIWNA) following a road accident in a 52-year-old woman, emphasizing the clinical nuances and management challenges associated with this condition.The patient presented with tetraplegia (American Spinal Injury Association Impairment Scale D) with a neurological injury level at C4, exhibiting subtle improvements during inpatient care. Comprehensive examinations revealed conflicting clinical and imaging findings, leading to the diagnosis of SCIWNA. A tailored rehabilitation program involving a multidisciplinary team resulted in notable improvements in neuromotor function, gait, and activities of daily living.The mechanisms behind SCIWNA in adults remain debated, possibly involving pre-existing spinal pathologies exacerbated by trauma. Neurological deficits can range from minor sensory issues to severe tetraplegia with unpredictable times of onset. Diagnostic challenges persist due to normal imaging results despite clinical symptoms. Treatment guidelines lack consensus, encompassing conservative approaches, steroid administration, and surgical interventions in select cases. This rare case of SCIWNA underscores the diagnostic complexity when clinical spinal cord injury contrasts with normal neuroimaging. This report highlights the significance of clinical assessment and the evolving landscape in diagnosing SCIWNA in adults. In addition, the absence of a standardized management protocol emphasizes the need for individualized strategies tailored to patient-specific needs, warranting further research and consensus-building among healthcare professionals.

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Section: Discussionmentioning

confidence: 99%

Inpatient Multidisciplinary Rehabilitation in Adult Spinal Cord Injury Without Neuroimaging Abnormality (SCIWNA): A Case Report

Neto,

Ribeiro,

Guimaraes

et al. 2024

Cureus

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Treatment of chronic neuropathic pain after traumatic central cervical cord lesion with gabapentin

Haller

Leblhuber²,

Trenkler³

et al. 2003

Journal of Neural Transmission

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Central cord syndrome may be associated with severe pain, resistant to conventional pain therapy regimens. Chronic pain may be a persistent problem in rehabilitation of spinal cord injuries. These pain syndromes are long lasting and challenging to treat. Gabapentin has been shown to be useful in treatment of different conditions which may be caused by increased neuronal excitability. This report describes a case where central cord syndrome and its chronic neuropathic pain associated with allodynia was successfully treated with gabapentin.

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Hemiparesis following sunbathing

Braiteh

Abrahams

2006

The American Journal of Emergency Medicine

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Adult spinal cord injury without radiological abnormality

Abstract: This paper describes some of the injuries sustained by the aircrew who ejected from their aircraft after a mid-air collision, and discusses the types of injury that such patients may suVer.

Cited by 5 publications

References 5 publications

Inpatient Multidisciplinary Rehabilitation in Adult Spinal Cord Injury Without Neuroimaging Abnormality (SCIWNA): A Case Report

Inpatient Multidisciplinary Rehabilitation in Adult Spinal Cord Injury Without Neuroimaging Abnormality (SCIWNA): A Case Report

Treatment of chronic neuropathic pain after traumatic central cervical cord lesion with gabapentin

Hemiparesis following sunbathing

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