Document Detail

Cruciate paralysis, hypothesis for injury and recovery.
MedLine Citation:
PMID:  10762188     Owner:  NLM     Status:  MEDLINE    
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.
M J Hatzakis; N Bryce; R Marino
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Spinal cord     Volume:  38     ISSN:  1362-4393     ISO Abbreviation:  Spinal Cord     Publication Date:  2000 Feb 
Date Detail:
Created Date:  2000-05-09     Completed Date:  2000-05-09     Revised Date:  2011-06-06    
Medline Journal Info:
Nlm Unique ID:  9609749     Medline TA:  Spinal Cord     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  120-5     Citation Subset:  IM    
Department of Rehabilitation Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania 19104, USA.
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MeSH Terms
Arm / innervation*
Cervical Vertebrae / injuries,  radiography
Foreign-Body Migration / complications,  radiography
Fractures, Bone / complications,  radiography,  therapy
Middle Aged
Odontoid Process / injuries,  radiography
Paralysis / etiology*
Wounds, Gunshot / complications,  radiography

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