Delayed central cord syndrome after a handstand in a child: case report

Central cord syndrome in a 7-year-old boy secondary to standing high jump

Acute traumatic central cord syndrome is commonly associated with major trauma such as falling and motor vehicle crash, but minor or nontraumatic causes are very rare in children. As a consequence, most physicians frequently overlook children presenting with complaints of arm weakness when history of any definite major trauma does not exist, especially in the emergency department. We present the case of a 7-year-old boy who was experiencing weakness in both arms after a standing high jump with tilting his head back in school. He had no history of any definite trauma and no evidence of bone abnormalities on plain radiography and computed tomography of the cervical spine. Magnetic resonance imaging of the cervical spine revealed observable swelling with increased signal intensity at C1 to 4 levels. This case showed a spinal cord injury caused by standing high jump with neck extension alone. Therefore, the physicians have to consider the possibility of spinal cord injury even without any history of major trauma.

Reconstruction of the upper extremity in the child with tetraplegia

According to Howard H. Steel, the orthopedic surgeon who first recognized the need for special care for children with spinal cord injury (SCI), and who persuaded Shriners Hospitals to establish specialized programs for these children over 20 years ago, no field of the health sciences is the statement "a child is not a small adult" more apropos than in the arena of trauma to the spinal cord. Children and adolescents with tetraplegia differ in many ways from adults with the disease. The dissimilarities that influence the outcome of surgical reconstruction of the upper extremity are the focus of this article.