Delayed presentation of unstable cervical spine injury with minimal symptoms.
Emergency physicians are less likely to suspect the presence of a severe or unstable cervical spine injury in patients who have been ambulatory since the traumatic episode. We present the case of a man with multiple cervical fractures and a 75% anterior subluxation of C6 and C7 who did not seek medical care for six weeks after falling from a height. Previous reports of delayed or occult cervical spine injuries are reviewed. Physicians must aggressively search for injuries whenever a history of neck pain is present or a strong mechanism of injury exists, even if the patient has been ambulatory for days or weeks following the injury.
Cox
G R
GR
Department of Surgery, University of Maryland Medical System Hospital, Baltimore 21201.
Barish
R A
RA
D000058:Accidental Falls; D000368:Aged; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D006801:Humans; D008297:Male; D016103:Spinal Fractures / Q000175:diagnosis* / Q000000981:diagnostic imaging; D013997:Time Factors; D014057:Tomography, X-Ray Computed