RT Journal Article
SR Electronic
T1 Spinal cord injury without radiological abnormality (SCIWORA). A diagnosis that is missed in unconscious children
JF Neurosciences Journal
JO Neurosciences (Riyadh)
FD Prince Sultan Military Medical City
SP 437
OP 440
VO 13
IS 4
A1 Essam A. Elgamal
A1 Sherif Elwatidy
A1 Amr M. Zakaria
A1 Aly A. Abdel-Raouf
YR 2008
UL http://nsj.org.sa/content/13/4/437.abstract
AB 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.