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Arm And Leg Weakness And Numbness After MVC


Consult Page

55M hx of C4-6 fusion presenting with loss of sensation and weakness in right arm after MVC

Initial Imaging

Fig. 40.1, A. Sagittal cervical spine CT without contrast demonstrates the patient’s known anterior fusion from C4 to C6 as well as sclerotic endplate changes at C3-C4. There is also grade I retrolisthesis of C3 on C4. B. Axial view at C3-C4 demonstrates severe stenosis at this level. There are no obvious fractures.

Fig. 40.2, Sagittal (A) and axial (B) STIR sequences of a cervical spine MRI without contrast demonstrates severe C3-C4 stenosis with increased STIR signal change of the spinal cord at this level. There is no obvious ligamentous injury or disruption.

Walking Thoughts

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    What are the patient’s current ABCs? Has the trauma team evaluated him yet?

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    What is the severity of the patient’s motor and sensation deficits? Is he weak in the right arm only or also in other extremities?

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    What is the patient’s prior surgical history? When was the surgery and why did he have surgery?

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    Does the patient have any other injuries?

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    What is his other medical history?

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    Is he taking any antiplatelet or anticoagulant medications?

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