title: Bilateral multiple cervical root avulsions without skeletal or ligamentous damage resulting from blast injury: case report.
abstract: OBJECTIVE
  We describe a unique case of multiple bilateral cervical root injuries without ligamentous or bony injury secondary to a sandblast accident.
  
  
  METHODS
  A 19-year-old man sustained a sandblast injury to his face, neck, chest, and upper extremities, with immediate loss of motor and sensory function occurring in both of his upper extremities. Cervical spine x-rays, computed tomography, and magnetic resonance imaging demonstrated no fracture, soft tissue abnormality, or malalignment. The restriction of deficits to the patient's upper extremities suggested a central cervical spinal cord injury, bilateral brachial injuries, or a conversion disorder.
  
  
  METHODS
  Cervical computed tomographic myelography revealed multiple bilateral nerve root injuries.
  
  
  CONCLUSIONS
  This case report is unique in the literature in that it describes a patient with multiple cervical nerve root injuries secondary to sandblast injury without ligamentous or bony injury. Although magnetic resonance imaging remains the diagnostic modality of choice in patients with acute spinal cord injury, it is deficient in demonstrating cervical root injury in the acute setting. In this setting, computed tomographic myelography is superior.
authors.affiliation: Division of Neurosurgery, University of Missouri-Columbia, Columbia, Missouri 65212, USA. doctorx@missouri.edu
authors.forename: John David
authors.initials: JD
authors.lastname: Morenski
authors.forename: Anthony M
authors.initials: AM
authors.lastname: Avellino
authors.forename: J Paul
authors.initials: JP
authors.lastname: Elliott
authors.forename: H Richard
authors.initials: HR
authors.lastname: Winn
mesh_terms: D000328:Adult; D001753:Blast Injuries / Q000175:diagnosis*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009192:Myelography; D009333:Neck; D013126:Spinal Nerve Roots / Q000293:injuries*; D014057:Tomography, X-Ray Computed; D020196:Trauma, Nervous System / Q000175:diagnosis*