Dual spinal cord injury: a case of acute traumatic T9 AIS A spinal cord injury complicated by transverse myelitis

Spinal Cord Series and Cases, 2020 · DOI: https://doi.org/10.1038/s41394-020-00329-7 · Published: August 11, 2020

Spinal Cord Injury Neurology Rehabilitation

Simple Explanation

This case report discusses a 17-year-old female who initially presented with a T9 AIS A traumatic spinal cord injury after a motor vehicle accident. Two days after surgery, she was admitted for inpatient rehabilitation. However, she later developed ascending weakness and hyperpyrexia, leading to a diagnosis of transverse myelitis (TM). After treatment with high-dose steroids and IVIG, she showed nearly complete recovery, returning to post-trauma baseline scores for both strength and sensation during a 6-month follow-up.

Study Duration

6-month follow-up

Participants

17 year old Caucasian female

Evidence Level

Case Report

Key Findings

1
The patient, initially diagnosed with a T9 AIS A SCI, was re-graded as C6 AIS A SCI following the diagnosis of transverse myelitis.
2
Following treatment for TM, the patient displayed post-trauma baseline scores for strength and sensation, indicating nearly complete recovery.
3
Prompt recognition and treatment of transverse myelitis by multiple team members enabled the patient to make a complete functional recovery from her inflammatory injury.

Research Summary

This case report presents a rare instance of transverse myelitis (TM) complicating an acute traumatic spinal cord injury (SCI) in a 17-year-old female. The patient's condition deteriorated post-surgery, leading to a diagnosis of TM spanning C2 to T11 levels, which was confirmed by CSF analysis and MRI findings. Early intervention with high-dose steroids and IVIG, coupled with diligent clinical management, resulted in the patient's nearly complete functional recovery, highlighting the importance of rapid diagnosis and treatment.

Practical Implications

Importance of Vigilance

Providers should remain vigilant for unexpected complications, even in seemingly stable rehabilitation patients.

Team Communication

Effective communication among all team members is crucial for prompt recognition and treatment of neurological deterioration.

Early Intervention

Early diagnosis and treatment of transverse myelitis with high-dose steroids can significantly improve patient outcomes and prevent long-term deficits.

Study Limitations

1
Case report only provides evidence from a single patient experience
2
Generalizability to other populations may be limited due to individual patient factors
3
Report relies on clinical assessments and imaging, potentially subject to interpretation bias

Your Feedback

Was this summary helpful?

Back to Spinal Cord Injury