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Italian Journal of Emergency Medicine 2020 April;9(1):58-61

DOI: 10.23736/S2532-1285.20.00012-9

Copyright © 2020 THE AUTHORS

This is an open access article distributed under the terms of the CC BY-NC-ND 4.0 license which allows users to copy and distribute the manuscript, as long as this is not done for commercial purposes and further does not permit distribution of the manuscript if it is changed or edited in any way, and as long as the user gives appropriate credits to the original author(s) and the source (with a link to the formal publication through the relevant DOI) and provides a link to the license.

language: English

Adult acute quadriparesis after traumatism: is it Spinal Cord Injury WithOut Radiologic Abnormality (SCIWORA)?

Mariachiara MICHELINI 1 , Maria S. COTELLI 2, Giacomina TOMASINI 1, Marta BIANCHI 2, Patrizia CIVELLI 2, Patrizia LAVEZZI 3, Marinella TURLA 2, Filippo MANELLI 1

1 Department of Emergency, Azienda Socio Sanitaria Territoriale Valcamonica Esine, Brescia, Italy; 2 Unit of Neurology, Azienda Socio Sanitaria Territoriale Valcamonica Esine, Brescia, Italy; 3 Unit of Radiology, Azienda Socio Sanitaria Territoriale Valcamonica Esine, Brescia, Italy

BACKGROUND: The acronym SCIWORA (Spinal Cord Injury Without Radiographic Abnormality) was first developed and introduced by Pang and Wilberger in 1982, who used it to define “clinical symptoms of traumatic myelopathy with no radiographic or computed tomographic features of spinal fracture or instability.” Based on reports from different authors, SCIWORA is responsible for 6 to 19% and 9% to 14% of spinal injuries in children and adults, respectively. The prevalence of this condition is highest among children below 8 years of age who also have the most unfavorable prognosis. wide spectrum of neurological dysfunction, ranging from mild, transient spinal cord concussive deficits to permanent, complete injuries of the spinal cord. Diagnosis is based on computer tomography, x-rays and magnetic resonance imaging.
METHODS: We report the case of an adult woman who received diagnosis of SCIWORA, evaluated in our Department of Emergency due to sudden quadriparesis with neurological bladder after accidentally falling at home.
RESULTS: Spine magnetic resonance imaging showed D12 A1 type fracture for which camp corset was positioned. Our patient was discharged after one week with complete spontaneous regression of neurological signs.
CONCLUSIONS: Despite radiological presence of D12 fracture, we think that our patient can be diagnosed with type I SCIWORA, due to contemporary involvement of upper and lower limbs without cervical spinal cord injury and with complete and spontaneous remission.

KEY WORDS: Spinal cord; Wounds and injuries; Magnetic resonance imaging

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