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Erschienen in:
01.03.2008 | Case for Discussion
Post-traumatic syringomyelia producing paraplegia in an infant
Erschienen in: Child's Nervous System | Ausgabe 3/2008
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Background
Post-traumatic syringomyelia is described in adults after spinal trauma but extremely rarely seen in children, especially in the first year of life.
Materials and methods
We describe a boy who, at the age of 7 months, suffered spinal trauma during a car accident when he was held at his mother’s lap and suffered extreme flexion of his torso. He suffered a mid-shaft fracture of his right femur, treated with hip spica for 6 weeks. After removal of the spica, it was noticed that he was not moving his legs, but he had preserved pain sensation in the lower half of his trunk and legs. A spine magnetic resonance scan performed 2 months after the injury showed a compressed wedge fracture of the body of T5 vertebra, kyphosis and a large syringomyelia cavity extending from T4 to T8. He had two operations to control the syringomyelia with laminotomy–laminoplasty, dissection of the arachnoid adhesions initially and drainage of the cavity on the second operation, with only modest success. He remains paraplegic 7 years after the injury. He has received thoracic brace immediately after the first spinal operation, which avoided kyphosis.
Discussion
Spinal trauma is rare in the first year of life; hence, post-traumatic syringomyelia is very rarely seen in infants. Nevertheless, it should be suspected after a major trauma, in the presence of paraplegia. Surgical treatment of post-traumatic syringomyelia in young children has the additional consideration of post-laminotomy kyphosis; hence, thoracic brace should be used early.