Bilateral isolated C5 paralysis of the shoulder: Atypical presentation of a transdiscal C4-C5 cervical spine fracture
| Autor: | Pietro Laudato, Elisa Mareddu, Stefan Bauer, Aurélien Traverso |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
Shoulder medicine.medical_specialty Weakness Radiography Case Report Anterior cervical discectomy and fusion 03 medical and health sciences 0302 clinical medicine Sensation medicine Paralysis Humans Aged 80 and over Cervical Vertebrae/diagnostic imaging Cervical Vertebrae/injuries Cervical Vertebrae/surgery Paralysis/diagnosis Paralysis/etiology Spinal Fractures/diagnosis Spinal Fractures/diagnostic imaging Spinal Injuries C5 paralysis Transdiscal spine fracture cervical spine shoulder paralysis 030222 orthopedics business.industry General Medicine Occult Surgery medicine.anatomical_structure Cervical Vertebrae Spinal Fractures Upper limb Presentation (obstetrics) medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | BMJ case reports, vol. 14, no. 3 BMJ Case Rep |
| Popis: | After a low-energy fall, an 83-year-old man presented with bilateral weakness of the upper arms without loss of sensation associated with a rigid cervical spine (ankylosing spinal disorder, ASD). Because of an atypical presentation during history, examination and initial imaging, a late diagnosis of a transdiscal C4-C5 fracture was made by dynamic radiographs. Anterior cervical discectomy and fusion were performed with delay. Strength improved from grade C to D (American Spinal Injury Association classification) after surgery. To our knowledge, this is the first description of a bilateral, isolated upper limb C5 paralysis without any loss of sensation caused by a transdiscal C4-C5 fracture. A high clinical and diagnostic index of suspicion is mandatory to make the diagnosis. We present three clinical ‘Awareness Criteria’ (1: recognition of ASD; 2: high index of fracture suspicion; 3: necessary imaging) helping clinicians to safely and promptly diagnose occult spinal fractures in ASD. |
| Databáze: | OpenAIRE |
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