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Medical Forum / General / General / November 2004Question about spinal fracture
In her book "Saying Goodbye to Daniel: When Death is the Best Choice", Juliet Rothman writes about the story of her 21-year-old son, who became quadriplegic after a diving accident. Originally he was diagnosed with a C4-C5 fracture, and after the accident he was able to speak and breathe unaided. However, after the operation to reset his neck he became ventilator-dependent and lost the ability to speak. When weeks later he was seen by doctors from Craig's hospital in Colorado, they diagnosed him as a C1. Why could this have happened? Is it normal to have a gradual loss of function in spinal fractures, or is it more likely that the operation to reset his neck was bungled? Thanks, Marco > In her book "Saying Goodbye to Daniel: When Death is the Best Choice", > Juliet Rothman writes about the story of her 21-year-old son, who [quoted text clipped - 7 lines] > or is it more likely that the operation to reset his neck was bungled? > Thanks, Seems more likely that there was an undiagnosed fracture of C1. HMc > Seems more likely that there was an undiagnosed fracture of C1. Would such a fracture explain why the patient ended up with no feelings anywhere apart from the area around the eyes and the mouth? Marco >> Seems more likely that there was an undiagnosed fracture of C1. > > Would such a fracture explain why the patient ended up with no > feelings anywhere apart from the area around the eyes and the mouth? Yes, facial sensation is mediated by the trigeminal nerve (cranial nerve V), which comes off the brainstem, above C1. All other sensation is mediated via the spinal cord. HMc >>>Seems more likely that there was an undiagnosed fracture of C1. >> [quoted text clipped - 6 lines] > > HMc You actually promped me to think of the acronym for remembering which cranial nerves are sensory, motor, or both. I had to think a minute that NVII is motor (but that the chorda tympani runs part of it's path within the facial n.) Steve  SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 |
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