Stab wound of the neck: potential pitfalls in management

The authors describe the case history of a patient who was stabbed in the back of his neck with a knife and who later presented with a Brown-Séquard syndrome attributable to cervical spinal cord damage. Myelography and CT revealed a compressive extradural lesion shown at exploratory operation to be...

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Bibliographic Details
Published in:Archives of emergency medicine 1989-09, Vol.6 (3), p.225-229
Main Authors: Page, R D, Lye, R H
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Emergency Service, Hospital
England
Humans
Injuries of the nervous system and the skull. Diseases due to physical agents
Laminectomy
Male
Medical sciences
Myelography
Neck Injuries
Spinal Cord Injuries - diagnostic imaging
Spinal Cord Injuries - etiology
Spinal Cord Injuries - surgery
Traumas. Diseases due to physical agents
Wounds, Stab - complications
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Summary:The authors describe the case history of a patient who was stabbed in the back of his neck with a knife and who later presented with a Brown-Séquard syndrome attributable to cervical spinal cord damage. Myelography and CT revealed a compressive extradural lesion shown at exploratory operation to be a loculus of cerebrospinal fluid (CSF). The loculus had formed as a consequence of leakage of CSF through a dural tear caused by the knife. Evacuation of this loculus resulted in some neurological improvement. The necessity of obtaining a clear history and of performing a thorough clinical examination is explained. The need to admit patients in whom stab wounds of the neck have transgressed subcutaneous fat is reiterated. Early referral to a neurosurgeon is advised for those patients with neurological deficits.
ISSN:0264-4924
1472-0205
1472-0213
DOI:10.1136/emj.6.3.225