Case of April 2010

Clinical History:

A 55 years-old gentleman was presented with head injury by falling frozen meat hitting at vertex at work. He complained of neck pain, bilateral upper limb and right lower limb weakness, right upper limb and left lower limb numbness. Physical examination revealed bilateral upper limb power decreased to 3/5 and right lower limb power decreased to 4/5. There was decreased pinprick and light touch over right C5-C8 and left L4 to S2 dermatomes. No urinary bladder dysfunction was detected. Urgent plain CT brain and CT cervical spine were unremarkable. An urgent MRI C-spine was performed.

                            Fig. 1 T1 Sagittal                                                      Fig. 2 T2 Sagittal

                        Fig. 3 T2* Sagittal

                               Fig. 4 T1 Axial                                                          Fig. 5 T2 Axial