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Cervical injuries

The following is a summary of the systematic review findings up to the date of our most recent literature search. If you have a specific clinical case, we strongly recommend you read all of the relevant references as cited and look for additional material published outside our search dates.

 

  • 11 studies described cervical injuries 1-11
  • Age range: 1-48 months 

Presenting features

  • Many of the children presented with respiratory distress 1-10
  • Altered consciousness and/or neurological deficit were the second most common symptoms 1-10
  • Pain on movement of the neck was noted in 2 cases 4,7
  • 1 child was asymptomatic with a C5-6 fracture dislocation and mild cord compression (diagnosed during investigation after twin was abused) 9
  • Koumellis identified three children with cervical subdural haematoma (SDH) associated with abusive head trauma; in two cases the SDH extended to the sacral region 6

Injuries present

  • Musculoskeletal injury occurred at any point throughout the cervical spine 1-11
  • 1 case involved central cord syndrome of C1-7 2
  • 2 cases involved spinal cord injury without musculoskeletal injury 2,7

Co-existent abusive head trauma

  • Seven cases included a variety of intracranial injuries co-existent with cervical injury 1-3,6,7
  • The cervical injuries ranged throughout C1-7 1-3,6,7

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References

  1. Agner C, Weig SG. Arterial dissection and stroke following child abuse: case report and review of the literature. Childs Nervous System. 2005;21(5):416-420 [Pubmed]
  2. Feldman KW, Avellino AM, Sugar NF and Ellenbogen RG (2008 ) Cervical spinal cord injury in abused children. Pediatric Emergency Care 24(4):222-227 [Pubmed]
  3. Ghatan S, Ellenbogen RG. Pediatric spine and spinal cord injury after inflicted trauma. Neurosurgery Clinics of North America. 2002;13(2):227-233 [Pubmed]
  4. Gille P, Bonneville JF, Francois JY, Aubert D, Peltre G and Canal JP (1980) Fracture des pédicules de l'axis chez un nourrisson battu (Fracture of the pedicles of the axis in a battered infant). Chirurgie Pediatrique 21(5):343-344
  5. Kleinman PK and Shelton YA (1997) Hangman's fracture in an abused infant: imaging features. Pediatric Radiology 27:776-777 [Pubmed]
  6. Koumellis P, McConachie NS, Jaspan T. Spinal subdural haematomas in children with non-accidental head injury. Archives of Disease in Childhood. 2009;94(3):216-219.[Pubmed]
  7. Oral R, Rahhal R, Elshershari H and Menezes AH (2006) Intentional avulsion fracture of the second cervical vertebra in a hypotonic child. Pediatric Emergency Care 22(5):352-354 [Pubmed]
  8. Piatt JH, Jr and Steinberg M (1995) Isolated spinal cord injury as a presentation of child abuse. Pediatrics 96:780-782 [Article]
  9. Rooks VJ, Sisler C and Burton B (1998) Cervical spine injury in child abuse: report of two cases. Pediatric Radiology 28(3):193-195 [Pubmed]
  10. Thomas NH, Robinson L, Evans A, Bullock P. The floppy infant: a new manifestation of nonaccidental injury. Pediatric Neurosurgery. 1995;23(4):188-191 [Pubmed]
  11. Tran B, Silvera M, Newton A and Kleinman PK (2007) Inflicted T12 fracture-dislocation: CT/MRI correlation and mechanistic implications. Pediatric Radiology 37(11):1171-1173 [Pubmed]

 

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