Clinical Reasoning: A 24-Year-Old Woman With Penetrating Neck Injury From a Needlefish.

Neurology

From the Division of Neurosurgery (A.P.W.), Department of Surgery, University of Ottawa, The Ottawa Hospital; Faculty of Kinesiology (S.T.H.), University of Toronto; Division of Neurosurgery (Z.K., N.H.), Department of Surgery, University of British Columbia, Royal Columbian Hospital, New Westminster; Department of Diagnostic Radiology (U.-E.E.), Dalhousie University, QEII Health Sciences Centre, Halifax; Division of Neurology (R.F.), Department of Medicine, University of Ottawa, The Ottawa Hospital; and Division of Neurology (G.B.W.), Department of Medicine, University of British Columbia, Royal Columbian Hospital, New Westminster, Canada.

Published: March 2024

Evaluating patients with a traumatic spinal cord injury can be complicated by other injuries. In this case, a 24-year-old woman injured by a needlefish presented with combined motor and sensory defects, cranial nerve deficits, and a blunt vascular injury. This case highlights the importance of neurologic and vascular localizations and an understanding of spinal cord injuries involving various ascending and descending tracts. Appreciation of these anatomical considerations through this case illustrates the diagnostic approach to neurologic evaluation. While we present a traumatic etiology for multiple neurologic syndromes, this case gives readers an opportunity to develop a comprehensive differential diagnosis and tailor investigations for other relevant etiologies. Readers walking through this stepwise process will ultimately arrive at several distinct but related diagnoses.

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Source
http://dx.doi.org/10.1212/WNL.0000000000209225DOI Listing

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