Skip to main navigation menu Skip to main content Skip to site footer
Padjadjaran of Nursing Journal

Case

Vol. 11 No. 3 (2023): Jurnal Keperawatan Padjadjaran

Traumatic lumbar hematomyelia causing spinal shock: A case report

DOI
https://doi.org/10.24198/jkp.v11i3.2352
Submitted
August 7, 2023
Published
2023-12-01

Abstract

Background: Spinal cord hemorrhage or hematomyelia can arise from trauma or non-trauma causes, adverse effect of anticoagulation therapy and ruptured vascular malformation. Bleeding in epidural space is common and complications such as acute spinal cord syndrome can arise due to the compression and destruction of the spinal cord. Symptoms of hematomyelia might be varied depending on location of the lesion, often accompanied with acute radicular pain. In this case study, we reported a case of spinal shock after traumatic lumbar hematomyelia. Case: A 13-year-old girl presented to Dr. Moewardi General Hospital with inferior paraparesis, bladder and bowel incontinence, a day after falling on her gluteus. Physical examination revealed reduced motoric and sensory function below 12th thoracal dermatome, with no patellar and reduced Achilles reflexes. Conventional X-ray was unremarkable and further investigation with MRI showed a hematoma on thoracal 10 to 12 vertebrae. Motor and sensory functions were improved after 12 days administration of corticosteroids and further improvement was seen almost immediately after decompression surgery. Objective: To describe a case of spinal shock caused by traumatic lumbar hematomyelia Method: This is a case report study describing spinal shock which improved after administration of corticosteroid and decompression surgery. Conclusion: Spinal shock could be caused by traumatic lumbar hematomyelia, which is characterized by loss of motor, sensory, and bladder function, and decompression surgery improved the prognosis.

Article Matrics
Abstract views : 160 times PDF Downloads: 81

Downloads

Download data is not yet available.

References

  1. Bennett, J., M Das, J., & Emmady, P. D. (2022). Spinal Cord Injuries.
  2. Berkowitz, A. L. (2022). Vascular Diseases of the Brain & Spinal Cord. In Clinical Neurology & Neuroanatomy: A Localization-Based Approach, 2e. McGraw Hill. http://accessmedicine.mhmedical.com/content.aspx?aid=1193764483
  3. Birua, G. (2019). Acute Monoplegia Due to Spinal Injury. Indian Journal of Neurosurgery, 08. https://doi.org/10.1055/s-0039-1694851
  4. Canseco, J. A., Karamian, B. A., Bowles, D. R., Markowitz, M. P., DiMaria, S. L., Semenza, N. C., Leibensperger, M. R., Smith, M. L., & Vaccaro, A. R. (2021). Updated Review: The Steroid Controversy for Management of Spinal Cord Injury. World Neurosurgery, 150, 1–8. https://doi.org/10.1016/j.wneu.2021.02.116
  5. Chen, S. F., Lee, Y. K., & Kuo, H. C. (2022). Satisfaction with Urinary Incontinence Treatments in Patients with Chronic Spinal Cord Injury. Journal of Clinical Medicine, 11(19). https://doi.org/10.3390/jcm11195864
  6. Claro, E., Dias, A., Girithari, G., Massano, A., & Duarte, M. A. (2018). Non-traumatic Hematomyelia: A Rare Finding in Clinical Practice. European Journal of Case Reports in Internal Medicine, 5(11), 961. https://doi.org/10.12890/2018_000961
  7. Dave S, D. J. (2023). Neurogenic Shock. Treasure Island (FL): StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK459361/?report=classic
  8. Ditunno, J. F., Little, J. W., Tessler, A., & Burns, A. S. (2004). Spinal shock revisited: A four-phase model. Spinal Cord, 42(7), 383–395. https://doi.org/10.1038/sj.sc.3101603
  9. Dorsher, P. T., & McIntosh, P. M. (2012). Neurogenic bladder. Advances in Urology, 2012. https://doi.org/10.1155/2012/816274
  10. Figliuzzi, A., Alvarez, R., & Al-Dhahir, M. A. (2022). Achilles Reflex.
  11. Francis, K. (2007). Physiology and management of bladder and bowel continence following spinal cord injury. Ostomy/Wound Management, 53(12), 18–27.
  12. Gahlot, N., & Elhence, A. (2020). Traumatic thoracic spine intramedullary hemorrhage: Rare spinal cord injury YR - 2020/1/1. Indian Spine Journal, 1 UL-https://www.isjonline.com/article.asp?issn=2589-5079;year=2020;volume=3;issue=1;spage=123;epage=126;aulast=Gahlot;t=5, 123 OP-126 VO – 3. https://doi.org/10.4103/isj.isj_72_18
  13. Kaakinen, J. R., Coehlo, D. P., Steele, R., Tabacco, A., & Hanson, S. M. H. (2015). Family Health Care Nursing.
  14. King, B., Pecanac, K., Krupp, A., Liebzeit, D., & Mahoney, J. (2018). Impact of Fall Prevention on Nurses and Care of Fall Risk Patients. Gerontologist, 58(2), 331–340. https://doi.org/10.1093/geront/gnw156
  15. Ko, H. Y. (2018). Revisit spinal shock: Pattern of reflex evolution during spinal shock. Korean Journal of Neurotrauma, 14(2), 47–54. https://doi.org/10.13004/kjnt.2018.14.2.47
  16. Kumar, R., Lim, J., Mekary, R. A., Rattani, A., Dewan, M. C., Sharif, S. Y., Osorio-Fonseca, E., & Park, K. B. (2018). Traumatic Spinal Injury: Global Epidemiology and Worldwide Volume. World Neurosurgery, 113, e345–e363. https://doi.org/10.1016/j.wneu.2018.02.033
  17. Montejano-Lozoya, R., Miguel-Montoya, I., Gea-Caballero, V., Mármol-López, M. I., Ruíz-Hontangas, A., & Ortí-Lucas, R. (2020). Impact of nurses’ intervention in the prevention of falls in hospitalized patients. International Journal of Environmental Research and Public Health, 17(17), 1–13. https://doi.org/10.3390/ijerph17176048
  18. Nunes, R. H., Abello, A. L., & Castillo, M. (2016). Critical findings in neuroradiology. In Critical Findings in Neuroradiology. https://doi.org/10.1007/978-3-319-27987-9
  19. Oh, H.-M., Nam, T.-W., Kim, J.-H., & Jung, T.-D. (2018). Effects of rehabilitation on spontaneous intramedullary spinal cord hemorrhage (hematomyelia) patient without surgery: A case report. Medicine, 97(48), e13414. https://doi.org/10.1097/MD.0000000000013414
  20. Pegat, B., Sophie, D., Morandi, X., & Edan, G. (2015). Spinal cord hemorrhage in a patient with neurosarcoidosis on long-term corticosteroid therapy: Case report. BMC Neurology, 15, 123. https://doi.org/10.1186/s12883-015-0373-6
  21. Perez, N. E., Godbole, N. P., Amin, K., Syan, R., & Gater, D. R. (2022). Neurogenic Bladder Physiology, Pathogenesis, and Management after Spinal Cord Injury. Journal of Personalized Medicine, 12(6). https://doi.org/10.3390/jpm12060968
  22. Pertami, S. B., Sulastyawati, & Anami, P. (2017). Effect Of 30 ° Head-Up Position on Intracranial Pressure Change in Patients with Head Injury In Surgical Ward of General Hospital of Dr . R . Soedarsono Pasuruan. Public Health of Indonesia, January 2019.
  23. Ramazanov, G. R., Talypov, A. E., Akhmatkhanova, L. K. B., Kanibolotsky, A. A., & Petrikov, S. S. (2021). Hematomyelia as a consequence of arteriovenous malformation disruption. Russian Neurological Journal, 26(3), 40–45. https://doi.org/10.30629/2658-7947-2021-26-3-40-45
  24. Sabouri, M., Rezvani, M., Aminmansour, B., Sourani, A., & Baradaran Mahdavi, S. (2022). Spontaneous intramedullary hematoma in a patient with COVID-19 infection: A case report. In Clinical case reports (Vol. 10, Issue 2, p. e05387). https://doi.org/10.1002/ccr3.5387
  25. Salazar-Muñoz, Y., López-Pérez, G. A., García-Caballero, B. E., Muñoz-Rios, R., Ruano-Calderón, L. A., & Trujillo, L. (2019). Classification and Assessment of the Patelar Reflex Response through Biomechanical Measures. Journal of Healthcare Engineering, 2019, 1614963. https://doi.org/10.1155/2019/1614963
  26. Soertidewi, L., Misbach, J., Sjahrir, H., Hamid, A., Jannis, J., & Bustami, M. (2006). Konsensus Nasional Penanganan Trauma Kapitis dan Trauma Spinal. Penerbit: Perhimpunan Dokter Spesialis Saraf Indonesia (PERDOSSI), 1–18.
  27. van Middendorp, J. J., Goss, B., Urquhart, S., Atresh, S., Williams, R. P., & Schuetz, M. (2011). Diagnosis and prognosis of traumatic spinal cord injury. Global Spine Journal, 1(1), 1–8. https://doi.org/10.1055/s-0031-1296049
  28. Wisconsin Hospital Association. (2007). The Color of Safety.
  29. Ziu, E., & Mesfin, F. B. (2022). Spinal Shock.