Failure of initial neurologic assessment for SCIWORA with brain injury in 22-month-old patient

ABSTRACT

Spinal cord injury without radiological abnormality (SCIWORA) is a unique concern in pediatric spine injuries. The incidence of pediatric spinal injuries is relatively low, with cervical spine being the most frequently involved in young children. The immature anatomical structure of the cervical spine in young children is attributable to the occurrence of SCIWORA. The author had experienced a case of failure to detect the spinal cord injury during the initial neurologic assessment in the emergency room, in a 22-month-old girl who had suffered a brain injury subsequent to a traffic accident. Since the brain injury resulted in decreased mentality and posttraumatic seizure, precise motor and sensory examinations were not performed, thereby resulting in the missed spinal cord injury during initial diagnosis.