Naslov
Posttraumatic locked-in syndrome without bilateral posttraumatic occlusion of the vertebral and basilar arteries - a case report

Autori
Golubović, Snježana ; Muhvić, Damir ; Golubović, Vesna ; Antončić, Igor

Izvornik
Neurologia Croatica. Supplement (1331-5196) 53 (2004), 2; 125-129

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, stručni

Ključne riječi
posttraumatic locked-in syndrome; cervical spine; hyperextension injury; pons

Sažetak
Abstract - we report a rare case of posttraumatic locked-in syndrome (LIS) developed after pontine contusion without bilateral posttraumatic occlusion of the vertebral and basilar arteries in a 23-year old patient poly-traumatized in a car accident. He sustained an acute injury of the cervical spine provoked by hyperextension and hyper-flexion of the neck during a rear-end car accident. During admission the patient was comatose and in a haemorrhagic shoch due to multiple organ lesions (lungs, liver, spleen). After urgent surgery the patient was admitted in ICU. After a few days he was conscious but tetraplegic with bilateral Babinski sign. He had a contusion of the ventrobasal pons shown on brain magnetic resonance imaging (MRI), low theta waves registered by electroencephalography (EEG), normal vascular anatomy registerd by brain angiography and normal X-rays of the cervical vertebrae. The patient was treated with antioedematous and antibiotic therapy and high doses of piracetam. He had frequent bacterial infections in spite of the antibiotic therapy according to antibiogram and finally after 105 days developed pneumonia and sepsis with the lethal outcome. During treatment in ICU the patient had moderate neurological improvement -he was able to open and close his eyes and turn his head on verbal command. Posttraumatic LIS without posttraumatic occlusion of vertebral and basilar artery is a rarity with possible promising neurological recovery but the outcome is closely related to other injuries.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA