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Images in Neurology |

High Cervical Spinal Cord Complete Transection

Arturo Chieregato, MD
Arch Neurol. 2008;65(8):1126. doi:10.1001/archneur.65.8.1126.
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A 66-year-old man fell from a height of 2 meters while at work. He was quickly attended to by an on-site physician who diagnosed cardiorespiratory arrest. The patient received ventilatory support using a laryngeal mask. He recovered cardiac activity and arterial pressure after epinephrine was administered.

On admission to the emergency department of the trauma center, the patient was unconscious. He had a Glasgow Coma Scale score of 3, arterial hypotension, and priapism. While a high-resolution multislice computed tomographic scan showed a fracture at the base of C2 and of its spinous process (Figure, A), the magnetic resonance image showed a complete transection of the cervical spinal cord at the C2 level (Figure, B). The patient was transferred 3 days later to a peripheral hospital intensive care unit where he died 8 days later due to respiratory failure.

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Figure.

A, High-resolution multislice computed tomographic scan showing the fracture of the base of epistropheus (left arrow) and of its spinous process (right arrow). B, In comparison, the T2 magnetic resonance image showing the complete cervical transection at the C2 level (arrow).

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