POSTERIOR PENETRATING INJURY OF THE NECK: A CASE REPORT

• Published in: Acta clinica Croatica (Tisak) 2018-12, Vol.57 (4), p.776-779
• Main Authors: Koruga, Nenad, Soldo Koruga, Anamarija, Butković Soldo, Silva, Kondža, Goran
• Format: Article
• Language: English
• Subjects: Angiography; Carotid Artery, Internal - diagnostic imaging; Case Reports; CAT scans; Computed Tomography Angiography - methods; Diagnostic imaging; Electromyography - methods; Humans; Magnetic Resonance Imaging - methods; Male; Middle Aged; Neck - blood supply; Neck - innervation; Neck injuries; Neck Injuries - diagnosis; Neck Injuries - etiology; Neck Injuries - physiopathology; Neck Injuries - surgery; Peripheral Nerve Injuries - surgery; Postoperative care; Postoperative Complications - diagnosis; Postoperative Complications - physiopathology; Radiculopathy; Radiculopathy - diagnosis; Radiculopathy - etiology; Radiculopathy - physiopathology; Signs and symptoms; Spinal Nerve Roots - diagnostic imaging; Surgery; Surgical Procedures, Operative - adverse effects; Surgical Procedures, Operative - methods; Tomography; Tomography, X-Ray Computed - methods; Treatment Outcome; Vertebral Artery - diagnostic imaging; Wounds, stab; Wounds, Stab - diagnosis; Wounds, Stab - physiopathology; Wounds, Stab - surgery
• ISSN: 0353-9466; 1333-9451
• DOI: 10.20471/acc.2018.57.04.22

- A 45-year-old male patient was admitted to the emergency unit due to posterior stab wound of the neck. The knife was directed diagonally from the left to the right side of the neck in the dorsoventral axis. The patient was fully conscious upon admission with pain and paresthesia along the upper right extremity. The patient underwent computed tomography (CT) and CT angiography scan of the neck, which revealed the knife blade piercing the left sided neck muscles and through the intervertebral ligaments of the C IV/C V in direction to the contralateral internal carotid artery, vertebral artery and the C5 nerve root. The patient underwent an urgent surgery according to the radiographs. Electromyography was performed during the early postoperative care and revealed an acute lesion of the right-sided C5 nerve root. Postoperative follow-up magnetic resonance imaging revealed intact brachial plexus bundles at the site of injury. Symptoms of reduced muscle strength and limited range of motion of the upper right extremity prevailed. Penetrating neck injuries represent a rare entity of all trauma injuries. Meticulous preoperative radiographs revealed close proximity of the knife blade tip to the right-sided vertebral artery and common carotid artery. Limited abduction at the right shoulder during postoperative period correlated to the C5 nerve root injury.