J Korean Soc Emerg Med.  2015 Aug;26(4):337-340. 10.0000/jksem.2015.26.4.337.

A Case of Traumatic Cardiac Arrest due to SCIWORA (Spinal Cord Injury without Radiographic Abnormality)

• Seo YW
• Kim GM
• Jang TC

• KMID: 2116804
• DOI: http://doi.org/10.0000/jksem.2015.26.4.337

Abstract

Spinal cord injury without radiographic abnormality (SCIWORA) is a rare injury and reported less frequently in adults than children. The symptoms and prognosis of SCIWORA are associated with injury level of the spinal cord, neurologic impairment, resolution rate, etc. High level injury of the spinal cord can lead to development of quadriplegia, paraplegia, spinal shock, cardiac dysfunction, and respiratory arrest. However initial presenting cardiac arrest is extremely rare in SCIWORA. Therefore we report on a cardiac arrest patient due to SCIWORA after a motorcycle accident. A 50-year-old male was an out of hospital cardiac arrest in a transferred hospital. At the time of local hospital arrival, he was in cardiac arrest state. Therefore he received endotracheal intubation and cardiopulmonary resuscitation for 5 minutes, and spontaneous circulation returned. In our hospital, he underwent whole body computed tomography and echocardiography. He had a fibular fracture and simple multiple rib fractures without pneumothorax and hemothorax. Magnetic resonance imaging showed spinal cord edema from the cervicomedullary junction to C3 level and ossification of the posterior longitudinal ligament at C2-3 level without bony abnormality. In unknown cause of traumatic cardiac arrest, high level spinal cord injury and further evaluation of the cervical spine may be needed.

Keyword

Spinal cord injuries; Sudden cardiac death; Motorcycles

MeSH Terms

Adult
Cardiopulmonary Resuscitation
Child
Death, Sudden, Cardiac
Echocardiography
Edema
Heart Arrest*
Hemothorax
Humans
Intubation, Intratracheal
Longitudinal Ligaments
Magnetic Resonance Imaging
Male
Middle Aged
Motorcycles
Out-of-Hospital Cardiac Arrest
Paraplegia
Pneumothorax
Prognosis
Quadriplegia
Rib Fractures
Shock
Spinal Cord
Spinal Cord Injuries
Spine