Traumatic Cervical Nerve Root Avulsion with Pseudomeningocele Formation
| Autor: | Ian T Watson, Eliel N Arrey, Phu Nguyen, Kennith F. Layton, Umair Khan, Dean Leonard, Suraj Sulhan, Ali S Haider |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Nerve root business.industry General Engineering medicine.disease 030218 nuclear medicine & medical imaging Surgery Avulsion Pseudomeningocele 03 medical and health sciences 0302 clinical medicine Epidural hematoma Hematoma Brachial plexus injury Cervical Nerve medicine business Brachial plexus 030217 neurology & neurosurgery |
| Zdroj: | Cureus. |
| ISSN: | 2168-8184 |
| Popis: | Cervical nerve root avulsion is a well-documented result of motor vehicle collision (MVC), especially when occurring at high velocities. These avulsions are commonly traction injuries of nerve roots that may be accompanied by a tear in the meninges through the vertebral foramina with associated collections of cerebrospinal fluid (CSF), thereby resulting in a pseudomeningocele. We present a case of a 19-year-old male who experienced an MVC and was brought to the emergency department (ED) with right arm paralysis and other injuries. A neurological examination demonstrated intact sensation but 0/5 muscle strength in the right upper extremity. A magnetic resonance imaging (MRI) of the spinal cord demonstrated massive epidural hematomas extending the length of the cervical spine caudally from C2. An MRI of the right brachial plexus showed C3-C7 anterior horn cell edema and associated traumatic nerve root avulsion with pseudomeningoceles on the right from C5-C8. The development of spinal cord hematoma with these injuries has rarely been documented in the literature and the multiple level avulsion described here with extensive hematoma is a rare clinical presentation. A literature review was conducted to determine the diagnostic requirements, treatment strategies, and complications of such an injury. Our patient received conservative treatment of the right brachial plexus injury and was transferred to an inpatient rehabilitation facility 13 days later. |
| Databáze: | OpenAIRE |
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