Clinical and anatomical observation of a patient with a complete lesion at C1 with maintenance of a normal blood pressure during 40 minutes after the accident.
The authors report on their clinical observations concerning a patient with a complete spinal cord injury at the level of C1, followed by a cardiac hypoxic arrest, due to immediate respiratory paralysis after the accident. Normal cardiac activity was obtained as a result of rapid resuscitation measures, using only intubation and external cardiac massage without any drug administration. The blood pressure was maintained without any drugs at a level of 130 Torr during 40 minutes before it fell to a permanent level of 50--40 Torr on ventilation alone. The diagnosis during the first hours was believed to be that of an irreversible coma with no evidence of vertebral injury. The patient started to recover consciousness after a few days but died on the 15th day. The case is discussed in the light of the literature and of the recent physiological experiments concerning the rapid changes of blood pressure after spinal cord section in animals.
D000293:Adolescent; D001794:Blood Pressure; D001926:Brain Death; D003128:Coma / Q000503:physiopathology; D004569:Electroencephalography; D006323:Heart Arrest; D006801:Humans; D008297:Male; D012018:Reflex; D012151:Resuscitation; D013119:Spinal Cord Injuries / Q000503:physiopathology*; D013997:Time Factors