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J Korean Soc Emerg Med > Volume 26(4); 2015 > Article
Journal of The Korean Society of Emergency Medicine 2015;26(4): 337-340.
SCIWORA 환자에서 발생한 외상성 심정지 1례
서영우, 김균무, 장태창
대구가톨릭대학교 의과대학 응급의학교실
A Case of Traumatic Cardiac Arrest due to SCIWORA (Spinal Cord Injury without Radiographic Abnormality)
Young Woo Seo, Gyun Moo Kim, Tae Chang Jang
Department of Emergency Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea
Correspondence  Tae Chang Jang ,Tel: 053) 650-4282, Fax: 053) 650-4930, Email: emzzang@cu.ac.kr,
Received: May 14, 2015; Revised: May 19, 2015   Accepted: June 8, 2015.  Published online: August 31, 2015.
ABSTRACT
Spinal cord injury without radiographic abnormality (SCIWORA) is a rare injury and reported less frequently in adults than children. The symptoms and prognosis of SCIWORA are associated with injury level of the spinal cord, neurologic impairment, resolution rate, etc. High level injury of the spinal cord can lead to development of quadriplegia, paraplegia, spinal shock, cardiac dysfunction, and respiratory arrest. However initial presenting cardiac arrest is extremely rare in SCIWORA. Therefore we report on a cardiac arrest patient due to SCIWORA after a motorcycle accident. A 50-year-old male was an out of hospital cardiac arrest in a transferred hospital. At the time of local hospital arrival, he was in cardiac arrest state. Therefore he received endotracheal intubation and cardiopulmonary resuscitation for 5 minutes, and spontaneous circulation returned. In our hospital, he underwent whole body computed tomography and echocardiography. He had a fibular fracture and simple multiple rib fractures without pneumothorax and hemothorax. Magnetic resonance imaging showed spinal cord edema from the cervicomedullary junction to C3 level and ossification of the posterior longitudinal ligament at C2-3 level without bony abnormality. In unknown cause of traumatic cardiac arrest, high level spinal cord injury and further evaluation of the cervical spine may be needed.
Key words: Spinal cord injuries, Sudden cardiac death, Motorcycles
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