Cervical spinal cord injury in abused children.
Five infants and toddlers who sustained cervical spinal cord injury as the result of child abuse are described. Three cases are previously unreported. Diagnosis was complicated by coexistent brain injuries and their treatments, subtle and/or evolving paralysis, and central cord syndrome, in which arm function is diminished but leg function is preserved. Definitive spinal imaging by magnetic resonance imaging (MRI), computed tomography, and plain radiographs was delayed because of life support efforts. When completed, the MRI was most sensitive to cord injury. Evidence of associated bony spinal injury was often absent or unapparent until healing occurred; 4 children had spinal cord injury without (or with minimal) radiological abnormality. The 3 children presenting to our hospital with cord injury represent 1% of the estimated cases of inflicted head injury seen during a 23-year period.
Feldman
Kenneth W
KW
General Pediatric Division, Department of Pediatrics, Department of Surgery, Children's Hospital and Regional Medical Center, and University of Washington School of Medicine, Seattle, WA, USA. kfeldman@u.washington.edu
Avellino
Anthony M
AM
Sugar
Naomi F
NF
Ellenbogen
Richard G
RG
D002574:Cervical Vertebrae; D002649:Child Abuse; D005260:Female; D006801:Humans; D007223:Infant; D011859:Radiography; D013119:Spinal Cord Injuries / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*