Bilateral medial medullary syndrome following anterior screw fixation of type 2 odontoid fracture, a case report of two patients
| Autor: | Bettina Pfausler, Anna Spicher, Dietmar Krappinger, Michael Zegg, Martha Nowosielski |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Brain Stem Infarctions business.industry Bone Screws Tetraparesis Case Report Dermatology Perioperative medicine.disease Surgery Screw fixation Lesion Fracture Fixation Internal Neurology Odontoid Process medicine Paralysis Cervical Vertebrae Humans Spinal Fractures medicine.symptom Medial medullary syndrome business Medulla Odontoid fracture |
| Zdroj: | Spinal Cord Ser Cases |
| ISSN: | 2058-6124 |
| Popis: | INTRODUCTION: Medial medullary syndrome (MMS) has not been reported after anterior screw fixation of an odontoid type 2 fracture. CASE PRESENTATION: We report on two cases who suffered from an unstable type 2 odontoid fracture following a skiing and a domestic fall accident. Prior to anterior screw fixation surgery both patients presented without neurologic deficits but postoperatively developed a bilateral MMS, including an incomplete tetraparesis, impaired sensation of position and movement as well as tactile discrimination and paralysis of the tongue muscle with deviation to the paralyzed side. MRI showed a typical heart-shaped ischaemic lesion in the medial medulla bilaterally. The search for aetiologic factors was uneventful in both patients except for severe atherosclerosis. DISCUSSION: Due to the close proximity of the ischaemic area to the surgical site, we here propose the perioperative mechanical manipulation of the upper cervical spine during surgery of patients with atherosclerosis as a new aetiology for MMS. |
| Databáze: | OpenAIRE |
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