Neonatal diagnosis of spinal cord transection

A case study is reported of an infant with a transection (break) of the spinal cord at the neck, which is the cervical portion of the spinal cord. The transection was eventually diagnosed by magnetic resonance imaging (MRI), a technique for visualizing the soft tissues of the body. The infant was born vaginally, but because he was in the breech position, forceps were used to turn him without apparent difficulty. At birth, the infant did not have any spontaneous movement or breathing. A breathing tube was inserted and the baby was placed on a respirator. He did not respond to stimuli and reflexes were absent. Marks from the forceps were present on the brain and neck. On day three, the newborn was still not breathing on his own and there was no spontaneous movement. X-rays of the spine were normal. Ultrasound examination of the head showed dilation of the cavities, but no bleeding. Computerized tomography (CT) showed evidence of bleeding in the brain. CT was repeated on day 18, showing similar results. The neurological status was appearing to improve, with a few spontaneous movements and the development of a few reflexes. On day 25, an MRI was performed, which showed the transection of the spinal cord. MRI provides excellent visualization of the spinal cord and is an important technique in the diagnosis of spinal cord injuries. The infant remained in the intensive care unit for eight weeks, with little improvement. He was then transferred to another hospital. Cervical spinal cord injury is not common, but can occur during vaginal delivery of infants in the breech position that are turned with forceps. (Consumer Summary produced by Reliance Medical Information, Inc.)