Name of the Patient : Abc XyzN. Glmn / M / 19 yrs.
Referred by : Dr. Abc Xyzgarwal.
Examination : M.R.I. of the Cervical Spine.
CLINICAL PROFILE :
Alleged H/O fall on 00.00.0000 with quadriplegia.
M.R.I of the cervical spine was performed using the following parameters :
5 mm thick T1 Weighted and T2 Weighted sagittal images.
5 mm thick T1 Weighted and Fast Scan (T2 *) axial images.
FEW IMAGES SHOW PATIENT MOTION.
There is retroplacement of the C5 vertebra over the C6 vertebra with resultant loss of normal cervical lordosis. The C5 vertebral body and laminae are fractured and the C5-C6 intervertebral disc is ruptured. There is discontinuity of the anterior and posterior longitudinal ligaments.
The C5 and C6 vertebral bodies appear hypointense on the T1 Weighted images and hyperintense on the T2 Weighted images. Fracture of the posterior elements of the C5 and C6 vertebrae is noted. A probable bone/disc fragment is noted in the anterior epidural space at the C6 vertebral level. A probable anterior epidural hematoma is also noted in the cervical region. There is resultant cord compression at the C5 vertebral level. The cervical spinal cord over the C1-C2 to D1 vertebral levels appears slightly increased in diameter and shows a hyperintense signal on the T2 Weighted and Fast Scan (T2 *) images (hypointense on the T1 Weighted images) suggesting cord contusion/edema/ischemia, in the given clinical setting.
Ill-defined, hyperintense signal on the T2 Weighted and Fast Scan (T2 *) images in the prevertebral space over the C1 to C5 vertebral levels represents a prevertebral hematoma/edema. Ill-defined hyperintense signal on the T2 Weighted and Fast Scan (T2 *) images in the paraspinal muscles in the cervical region would represent soft tissue contusion/edema.
The rest of the cervical vertebral bodies and the intervertebral discs show normal signal intensity. The joints of Luschka are unremarkable.
The atlanto-axial region and the cervico-medullary junction are unremarkable.
The left vertebral artery in the neck shows an intraluminal signal which may suggest slow flow/thrombus.
In a known C/O trauma, the MRI features suggest retroplacement of the C5 over the C6 vertebra with fracture of the C5 vertebral body and the posterior elements of the C5 and C6 vertebrae. The C5 and C6 vertebral bodies show evidence of bone bruise/edema. There is resultant cord compression at the C5 vertebral level with cord signal alteration in the cervical region, suggesting cord contusion/edema/ischemia. A prevertebral and probable anterior epidural hematoma is noted in the cervical region with soft tissue injury in the paraspinal muscles.
The cervical cord does not show complete transaction.