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Case ReportCASE REPORTS
Open Access

Spinal cord injury without radiological abnormality (SCIWORA). A diagnosis that is missed in unconscious children

Essam A. Elgamal, Sherif Elwatidy, Amr M. Zakaria and Aly A. Abdel-Raouf
Neurosciences Journal October 2008, 13 (4) 437-440;
Essam A. Elgamal
Neurosurgery Division (37), College of Medicine, King Khalid University Hospital, PO Box 7805, Riyadh 11472, Kingdom of Saudi Arabia. Tel. +966 (1) 4671273. Fax: +966 (1) 4679493. E-mail: [email protected]
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Sherif Elwatidy
Neurosurgery Division (37), College of Medicine, King Khalid University Hospital, PO Box 7805, Riyadh 11472, Kingdom of Saudi Arabia. Tel. +966 (1) 4671273. Fax: +966 (1) 4679493. E-mail: [email protected]
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Amr M. Zakaria
Neurosurgery Division (37), College of Medicine, King Khalid University Hospital, PO Box 7805, Riyadh 11472, Kingdom of Saudi Arabia. Tel. +966 (1) 4671273. Fax: +966 (1) 4679493. E-mail: [email protected]
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Aly A. Abdel-Raouf
Neurosurgery Division (37), College of Medicine, King Khalid University Hospital, PO Box 7805, Riyadh 11472, Kingdom of Saudi Arabia. Tel. +966 (1) 4671273. Fax: +966 (1) 4679493. E-mail: [email protected]
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Abstract

Spinal cord injury without radiographic abnormality (SCIWORA) usually occurs in the hypermobile, immature cervical spine of young children. In a comatose child, a normal spine x-ray, and CT scan exclude most cases of gross fracture and dislocation, but not SCIWORA. We present 2 children that sustained a polytrauma, which rendered each of them unconscious at the outset. In both, cervical spine x-ray excluded bony injuries, however, CT scan raised the suspicious of spinal cord injury in one, and MRI demonstrated significant cord injury in both. The first patient died from severe head and cervical spinal cord injury. The second patient recovered with mild Brown-Sequard syndrome. A high index of suspicious of SCIWORA is necessary in injured comatose children in whom movement of all limbs is not seen. Therefore, spine MRI should be considered if they are expected to remain ventilated for an unknown time.

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Neurosciences is an Open Access journal and articles published are distributed under the terms of the Creative Commons Attribution-NonCommercial License (CC BY-NC). Readers may copy, distribute, and display the work for non-commercial purposes with the proper citation of the original work.

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Neurosciences Journal: 13 (4)
Neurosciences Journal
Vol. 13, Issue 4
1 Oct 2008
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Spinal cord injury without radiological abnormality (SCIWORA). A diagnosis that is missed in unconscious children
Essam A. Elgamal, Sherif Elwatidy, Amr M. Zakaria, Aly A. Abdel-Raouf
Neurosciences Journal Oct 2008, 13 (4) 437-440;

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Spinal cord injury without radiological abnormality (SCIWORA). A diagnosis that is missed in unconscious children
Essam A. Elgamal, Sherif Elwatidy, Amr M. Zakaria, Aly A. Abdel-Raouf
Neurosciences Journal Oct 2008, 13 (4) 437-440;
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© 2025 Neurosciences Journal Neurosciences is copyright under the Berne Convention and the International Copyright Convention. All rights reserved. Neurosciences is an Open Access journal and articles published are distributed under the terms of the Creative Commons Attribution-NonCommercial License (CC BY-NC). Readers may copy, distribute, and display the work for non-commercial purposes with the proper citation of the original work. Electronic ISSN 1658-3183. Print ISSN 1319-6138.

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