| Cruciate paralysis, hypothesis for injury and recovery. | |
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MedLine Citation:
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PMID: 10762188 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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STUDY DESIGN: Case report and review of the literature. OBJECTIVES: Discuss a case of cruciate paralysis, a review of the literature and the hypotheses regarding the pathogenesis and recovery in spinal cord injuries that cause disproportionate weakness of the upper extremities. SETTING: Thomas Jefferson University Hospital, Philadelphia, PA, USA. METHODS: Case report. RESULTS: A case of cruciate paralysis is presented involving a 59-year-old female who experienced a gunshot wound to the face. Initial motor exams revealed mild lower limb weakness and absent upper limb function with an upper limb modified American Spinal Injury Association motor score of 0/50 (a modified impairment scale using half point muscle grades). Spinal imaging revealed fractures of the C1 anterior ring and the odontoid process, both associated with multiple bullet fragments. No spinal surgery was performed and she was placed in halo fixation. By 3 weeks she had regained enough upper limb function to manipulate large objects with her left hand and move her right hand. At that time, her upper limb ASIA score was 16/50. By 5 weeks, her upper limb modified ASIA motor score had improved to 31.5/50 and she began manipulating feeding utensils, writing legibly, and brushing her teeth with her left hand. CONCLUSIONS: In this case report we present a patient's motor and functional recovery. We also discuss the hypothesis that the acute central cord syndrome and cruciate paralysis are a likely result of similar pathologic mechanisms and that good functional outcome resulted from an initially disabling trauma. |
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Authors:
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M J Hatzakis; N Bryce; R Marino |
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Publication Detail:
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Type: Case Reports; Journal Article; Review |
Journal Detail:
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Title: Spinal cord Volume: 38 ISSN: 1362-4393 ISO Abbreviation: Spinal Cord Publication Date: 2000 Feb |
Date Detail:
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Created Date: 2000-05-09 Completed Date: 2000-05-09 Revised Date: 2011-06-06 |
Medline Journal Info:
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Nlm Unique ID: 9609749 Medline TA: Spinal Cord Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 120-5 Citation Subset: IM |
Affiliation:
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Department of Rehabilitation Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania 19104, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Arm
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innervation* Braces Cervical Vertebrae / injuries, radiography Female Foreign-Body Migration / complications, radiography Fractures, Bone / complications, radiography, therapy Humans Middle Aged Odontoid Process / injuries, radiography Paralysis / etiology* Wounds, Gunshot / complications, radiography |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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