A 66-year-old man fell from a height of 2 meters while at work. He was quickly attended to by an on-site physician who diagnosed cardiorespiratory arrest. The patient received ventilatory support using a laryngeal mask. He recovered cardiac activity and arterial pressure after epinephrine was administered.
On admission to the emergency department of the trauma center, the patient was unconscious. He had a Glasgow Coma Scale score of 3, arterial hypotension, and priapism. While a high-resolution multislice computed tomographic scan showed a fracture at the base of C2 and of its spinous process (Figure, A), the magnetic resonance image showed a complete transection of the cervical spinal cord at the C2 level (Figure, B). The patient was transferred 3 days later to a peripheral hospital intensive care unit where he died 8 days later due to respiratory failure.
Chieregato A. High Cervical Spinal Cord Complete Transection. Arch Neurol. 2008;65(8):1126. doi:10.1001/archneur.65.8.1126