Spinal cord injury without radiologic abnormality in children

Boese, Christoph Kolja; Oppermann, Johannes; Siewe, Jan; Eysel, Peer; Scheyerer, Max Joseph; Lechler, Philipp

doi:10.1097/ta.0000000000000579

Cited by 31 publications

(26 citation statements)

References 15 publications

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“…9 The neuroimaging findings are classified into MRI patterns. 1 In 43% of patients, no abnormalities were detectable by MRI (Type I), while 57% had abnormal scan results (Type II). Of these, 6% had extra neural abnormalities alone (Type IIa), while 38% showed isolated intraneural lesions (Type IIb).…”

Section: Discussionmentioning

confidence: 98%

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Upper extremity monoparesis in an adololescent without obvious profound etiology

Panagopoulos¹

2018

IJRRT

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Background: Spinal cord injury in children is associated with severe morbidity and immense socioeconomic burden. In spinal cord injury without radiologic abnormalities (SCIWORA), magnetic resonance imaging (MRI) can detect intramedullary or extramedullary pathologies or show absence of neuroimaging abnormalities. Pathogenesis of SCIWORA is based on the concept that the inherently elastic paediatric spinal column can afford significant degree of segmental dislocation, resulting in damage of the spinal cord, without any obvious spinal fracture or ligamentous disruption. Case presentation: The medical history of the patient includes only a delayed presentation of unilateral upper extremity weakness to a child after violent traction of neck and upper extremity. A Guilford-type brace was applied to the patient for 3 months and the neurological outcome was eventually relatively uneventful. The clinical and radiologic work-up, combined with the neurological findings, established the diagnosis of SCIWORA, and we are highlighting the clinical and radiological features. Conclusion: Review of the literature, regarding SCIWORA cases, reveals that the recognition of only edema of the spinal cord, without evidence of haemorrhage, as a positive predictive factor. SCIWORA should be included in the differential diagnosis of cases with paresis of the extremities, even though the possible traumatic event may manifest a significant time delay from the clinical sequelae, as it was the case for our patient.

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Section: Discussionmentioning

confidence: 98%

“…Spinal cord injury (SCI) in children is a challenging condition for the treating surgeon and paediatrician. 1 It is considered to be rare, with an estimated incidence of 4.6per million children per year. 2 Spinal cord injuries without radiologic abnormality (SCIWORA) were first described by Pang & Wilberger 3,4 in 1982.…”

Section: Introductionmentioning

confidence: 99%

Upper extremity monoparesis in an adololescent without obvious profound etiology

Panagopoulos¹

2018

IJRRT

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“…Hence, we were unable to investigate the frequency of cervical central spinal cord injury patterns among patients with SCIWORA. 12,13 In case reports, Jung et al 14 reported a 7-year-old boy who complained of weakness in both arms (but not his lower extremities) after completing a standing high jump. This case showed no evidence of bone abnormalities on computed tomography of the cervical spine, but MRI revealed observable swelling with increased signal intensity at the C1-C4 levels.…”

Section: Discussionmentioning

confidence: 99%

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

Nagasawa

Ishikawa

Takahashi

et al. 2017

Spinal Cord Ser Cases

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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.

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“…3,5 To further improve the interpretability and comparability of MRI findings in patients with a clinicoradiological mismatch, an MRI-based classification system has been introduced. 4,6 The present study aimed (1) to further characterise the clinical features of adult patients presenting with SCIWORA, (2) to apply the MRI classifications system in a consecutive cohort and (3) to assess its prognostic value in the prediction of the early neurological outcome in this population.…”

Section: Introductionmentioning

confidence: 99%

Spinal cord injury without radiographic abnormality (SCIWORA) in adults: MRI type predicts early neurologic outcome

et al. 2016

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Spinal cord injury without radiologic abnormality in children

Abstract: Systematic review, level IV.

Cited by 31 publications

References 15 publications

Upper extremity monoparesis in an adololescent without obvious profound etiology

Upper extremity monoparesis in an adololescent without obvious profound etiology

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

Spinal cord injury without radiographic abnormality (SCIWORA) in adults: MRI type predicts early neurologic outcome

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