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A Rare Case of Cord Infarction Following Electrocution: The Diagnostic Utility of Diffusion Weighted Imaging in the Spinal Cord. 2011

General Spine

Sean, C, Chang, M.D.
Jesse, G. A., Jones, M.D., Non ASSR Member
Mark, S., Shiroishi, M.D., Non ASSR Member
Warren, L., Garner, M.D., Non ASSR Member
Lerner, Alexander, M.D., Non ASSR Member
Go, L., John, M.D., Non ASSR Member

Excerpta

Purpose

To present a rare case of spinal cord infarction following electrocution as demonstrated by MRI diffusion weighted imaging.

Methods & Materials

The clinical documents and imaging studies of a 43 year old man brought to the trauma center in a cervical collar after sustaining third degree burns of his scalp, torso and lower extremities following high-voltage electrocution were reviewed.

Results

On admission, the patient was observed to voluntarily move all four extremities. MRI of the cervical spine at that time demonstrated a normal cervical cord. He was subsequently intubated and sedated for several days for burn surgery and ICU care. Upon extubation, he was noted to have quadriparesis. Repeat MRI at this time revealed interval development of spinal cord infarction as evident by increased cord diameter, increased T2 signal of the substance of the cord, which restricts on diffusion weighted imaging.

Conclusion

Spinal cord injury is thought to be a rare complication of electrocution. Thermal coagulation of small vessels supplying the spinal cord leading to infarction appears to play a major pathophysiologic role. Contributing factors such as direct nerve injury from electrical current have also been proposed. Patients who suffer immediate neurological symptoms typically recover over several days, whereas delayed onset heralds lasting injury. Further studies are needed to predict the subpopulation of electrocution victims prone to develop spinal cord injury and devise preventative strategies. To the best of our knowledge this is the first example in the literature documenting the use of diffusion weighted imaging to confirm spinal cord infarct following electrocution.

References/Financial Disclosures

1.Silversides J. The neurological sequelae of electrical injury. Can Med Assoc J 1964;91:195â