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Spinal Cord (2007) 45, 687689
& 2007 International Spinal Cord Society All rights reserved 1362-4393/07 $30.00
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Case Report Blunt cervical spine trauma as a cause of spinal cord injury and delayed cortical blindness
MT McCormick*,1, HK Robinson2, I Bone1, AN McLean2 and DB Allan2
1Department of Neurology, Institute of Neurological Sciences, Southern General Hospital, Glasgow, Scotland, UK;
2Queen Elizabeth National Spinal Injuries Unit, Southern General Hospital, Glasgow, Scotland, UKStudy design: Case report.
Objective: To present and discuss the case of a patient who sustained a signicant exion compression injury of the cervical spine with resulting tetraplegia and development of cortical blindness.
Setting: National Spinal Injuries Unit and Institute of Neurological Sciences, Southern General Hospital, Glasgow, Scotland, UK.
Methods: Clinical and radiological follow-up of the patient.
Results: Cortical blindness resulted from vertebral artery dissection associated with blunt cervical spine trauma. The patient is registered blind and is ventilator dependent.
Conclusion: The potential complications of blunt vertebral artery injury remain poorly recognised. Screening is routinely not performed. Advances in noninvasive radiological techniques may result in recognition of asymptomatic disease and the potential for therapeutic intervention.
Spinal Cord (2007) 45, 687689; doi:10.1038/sj.sc.3101995; published online 28 November 2006 Keywords: cervical spine; blunt trauma; cortical blindness; vertebral artery; dissection
Introduction Cerebrovascular insults following blunt cervical spine trauma were previously felt to be rare and of little practical signicance.1 Application of vascular imaging has unmasked a higher incidence than previously thought, with increased awareness of potentially severe neurological complications. We report the case of an adult male who developed cervical cord injury secondary to multiple cervical vertebrae fractures, resulting in tetraplegia. Cortical blindness subsequently developed as a result of occipital infarction secondary to bilateral vertebral artery dissections.
Case report A 30-year-old male dived head rst into a paddling pool and collapsed. He had a cardio-respiratory arrest and was resuscitated at the scene. On arrival at a local hospital, there was no movement in the upper or lower limbs, he was areexic and hypotonic, priapism was present, there was absent anal tone. Computerised
tomographic (CT) scan of the brain was normal. He was intubated and ventilated.
Imaging of his cervical vertebrae demonstrated multiple fractures involving the posterior C3 vertebral body, bilateral inferior articular facet fractures of C3; fracture through the anterior...