Cervical spinal cord injury by a low-impact trauma as an unnoticed cause of cardiorespiratory arrest

Background: Cardiorespiratory arrest (CA) secondary to traumatic cervical spinal cord injury can occur in minor accidents with low-impact trauma and may be overlooked as the cause of CA in patients admitted in the coronary care unit. Case summary: We present two patients admitted to the coronary car...

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Autores: Mayà Casalprim, Gerard, Ortiz Pérez, José Tomás, Tercero Uribe, Ana, Reyes, David, Iranzo, Alex, Santamaria Cano, Joan, Bosch Genover, Xavier, Gaig Ventura, Carles
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2020
País:España
Recursos:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/176464
Acesso em linha:https://hdl.handle.net/2445/176464
Access Level:acceso abierto
Palavra-chave:Medul·la espinal
Aturada cardíaca
Traumatisme
Spinal cord
Cardiac arrest
Traumatism
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spelling Cervical spinal cord injury by a low-impact trauma as an unnoticed cause of cardiorespiratory arrestMayà Casalprim, GerardOrtiz Pérez, José TomásTercero Uribe, AnaReyes, DavidIranzo, AlexSantamaria Cano, JoanBosch Genover, XavierGaig Ventura, CarlesMedul·la espinalAturada cardíacaTraumatismeSpinal cordCardiac arrestTraumatismBackground: Cardiorespiratory arrest (CA) secondary to traumatic cervical spinal cord injury can occur in minor accidents with low-impact trauma and may be overlooked as the cause of CA in patients admitted in the coronary care unit. Case summary: We present two patients admitted to the coronary care unit because of suspected CA of cardiac origin. Both patients were found in CA with asystole, one after collapsing in a shopping mall and falling down a few steps and the other in the street next to his bicycle. They underwent early pharmacologically induced coma and hypothermia precluding neurological examination. Both patients remained in coma after rewarming, with preserved brainstem reflexes but absent motor response to pain. One patient had post-anoxic myoclonus in the face without limb involvement. In both patients, median nerve somatosensory evoked potentials demonstrated bilateral absence of thalamocortical N19 responses and abnormal cervicomedullary junction potentials (N13 wave). Extensive diagnostic work-up did not find a cardiac cause of the CA, pulmonary thromboembolism, or intracranial haemorrhage. In both patients, cervical spinal cord injury was diagnosed incidentally 5 and 6 days after CA, when a brain magnetic resonance imaging performed to assess post-anoxic brain injuries detected spinal cord hyperintensities with fracture and luxation of the odontoid. Both patients died 11 and 8 days after CA. Discussion: Low-impact traumatic cervical spinal cord injury should be considered in the diagnostic work-up of patients with CA of unknown cause.Oxford University Press2020info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/176464Articles publicats en revistes (Medicina)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.1093/ehjcr/ytaa044European Heart Journal - Case Reports, 2020, vol. 4, num. 2https://doi.org/10.1093/ehjcr/ytaa044cc-by-nc (c) Mayà Casalprim, Gerard et al., 2020http://creativecommons.org/licenses/by-nc/3.0/esinfo:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/1764642026-05-27T06:46:51Z
dc.title.none.fl_str_mv Cervical spinal cord injury by a low-impact trauma as an unnoticed cause of cardiorespiratory arrest
title Cervical spinal cord injury by a low-impact trauma as an unnoticed cause of cardiorespiratory arrest
spellingShingle Cervical spinal cord injury by a low-impact trauma as an unnoticed cause of cardiorespiratory arrest
Mayà Casalprim, Gerard
Medul·la espinal
Aturada cardíaca
Traumatisme
Spinal cord
Cardiac arrest
Traumatism
title_short Cervical spinal cord injury by a low-impact trauma as an unnoticed cause of cardiorespiratory arrest
title_full Cervical spinal cord injury by a low-impact trauma as an unnoticed cause of cardiorespiratory arrest
title_fullStr Cervical spinal cord injury by a low-impact trauma as an unnoticed cause of cardiorespiratory arrest
title_full_unstemmed Cervical spinal cord injury by a low-impact trauma as an unnoticed cause of cardiorespiratory arrest
title_sort Cervical spinal cord injury by a low-impact trauma as an unnoticed cause of cardiorespiratory arrest
dc.creator.none.fl_str_mv Mayà Casalprim, Gerard
Ortiz Pérez, José Tomás
Tercero Uribe, Ana
Reyes, David
Iranzo, Alex
Santamaria Cano, Joan
Bosch Genover, Xavier
Gaig Ventura, Carles
author Mayà Casalprim, Gerard
author_facet Mayà Casalprim, Gerard
Ortiz Pérez, José Tomás
Tercero Uribe, Ana
Reyes, David
Iranzo, Alex
Santamaria Cano, Joan
Bosch Genover, Xavier
Gaig Ventura, Carles
author_role author
author2 Ortiz Pérez, José Tomás
Tercero Uribe, Ana
Reyes, David
Iranzo, Alex
Santamaria Cano, Joan
Bosch Genover, Xavier
Gaig Ventura, Carles
author2_role author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Medul·la espinal
Aturada cardíaca
Traumatisme
Spinal cord
Cardiac arrest
Traumatism
topic Medul·la espinal
Aturada cardíaca
Traumatisme
Spinal cord
Cardiac arrest
Traumatism
description Background: Cardiorespiratory arrest (CA) secondary to traumatic cervical spinal cord injury can occur in minor accidents with low-impact trauma and may be overlooked as the cause of CA in patients admitted in the coronary care unit. Case summary: We present two patients admitted to the coronary care unit because of suspected CA of cardiac origin. Both patients were found in CA with asystole, one after collapsing in a shopping mall and falling down a few steps and the other in the street next to his bicycle. They underwent early pharmacologically induced coma and hypothermia precluding neurological examination. Both patients remained in coma after rewarming, with preserved brainstem reflexes but absent motor response to pain. One patient had post-anoxic myoclonus in the face without limb involvement. In both patients, median nerve somatosensory evoked potentials demonstrated bilateral absence of thalamocortical N19 responses and abnormal cervicomedullary junction potentials (N13 wave). Extensive diagnostic work-up did not find a cardiac cause of the CA, pulmonary thromboembolism, or intracranial haemorrhage. In both patients, cervical spinal cord injury was diagnosed incidentally 5 and 6 days after CA, when a brain magnetic resonance imaging performed to assess post-anoxic brain injuries detected spinal cord hyperintensities with fracture and luxation of the odontoid. Both patients died 11 and 8 days after CA. Discussion: Low-impact traumatic cervical spinal cord injury should be considered in the diagnostic work-up of patients with CA of unknown cause.
publishDate 2020
dc.date.none.fl_str_mv 2020
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/176464
url https://hdl.handle.net/2445/176464
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1093/ehjcr/ytaa044
European Heart Journal - Case Reports, 2020, vol. 4, num. 2
https://doi.org/10.1093/ehjcr/ytaa044
dc.rights.none.fl_str_mv cc-by-nc (c) Mayà Casalprim, Gerard et al., 2020
http://creativecommons.org/licenses/by-nc/3.0/es
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by-nc (c) Mayà Casalprim, Gerard et al., 2020
http://creativecommons.org/licenses/by-nc/3.0/es
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Oxford University Press
publisher.none.fl_str_mv Oxford University Press
dc.source.none.fl_str_mv Articles publicats en revistes (Medicina)
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.301603

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