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Spinal cord ischaemic injury while playing in a playground
  1. Joana de Brito Chagas1,
  2. Candida Cancelinha1,2,
  3. Rui Pedro Pais3 and
  4. Carmen Costa4
  1. 1Paediatric Medical Service, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
  2. 2Paediatric University Clinic, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
  3. 3Medical Imaging Service, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
  4. 4Neuropaediatric Unit, Child Development Centre, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
  1. Correspondence to Dr Joana de Brito Chagas; joanabchagas{at}gmail.com

Abstract

Spinal cord ischaemia is a rare condition in children in which imaging diagnosis can be difficult and treatment guidelines are not well established. We describe a case of a previously healthy 13-year-old girl admitted to the emergency department with an acute flaccid paralysis of the lower limbs, abdominal and dorsal pain, and bladder dysfunction. A few hours earlier, she had been playing on a swing with hyperextension and an arched back position. Spinal cord MRI was normal in the first hours, but ischaemic signs were described in a second examination performed some hours later. We discuss the extensive investigation for differential diagnosis and the management of this case.

  • paediatrics
  • spinal cord
  • trauma CNS /PNS
  • neurological injury
  • neuroimaging

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Footnotes

  • Contributors All authors contributed to the clinical orientation of the patient presented and conceived the idea of writing this paper. JdBC wrote the manuscript. JdBC and CCa performed the literature review regarding this theme. CCa and CCo supervised the clinical aspects of the manuscript. RPP chose the images for the article and discussed it, considering clinical aspects. All authors discussed the clinical case and commented on the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer-reviewed.

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