Acute physical findings associated with or indicating traumatic cervical spinal cord injury
Acute physical findings associated with or indicating traumatic cervical spinal cord injury
Associated with cervical spinal cord injury
Altered mental status
Neck pain at rest or with isometric neck motion
Decreased active cervical spine range of motion
Posterior midline cervical spine tenderness
Muscle spasm of cervical spine muscles
Indicating cervical spinal cord injury
Upper or lower extremity paresthesias or pain
Sensory deficit below level of injury
Bilateral upper or lower extremity weakness or paralysis
Hyporeflexia*
Hypo- or hyperthermia
Diaphragmatic breathing without retractions
Hypotension with bradycardia (neurogenic shock)
Urinary retention or incontinence
Decreased rectal tone
Priapism
Unilateral ptosis and miosis (Horner syndrome) in association with cervical plexus injury
Cervical spinal cord injury should be suspected in all trauma patients with altered mental status, neck pain, and/or findings of possible cervical spine injury. Clinical findings of cervical spinal cord injury may develop over time and require a careful neurologic examination for detection.
* Hyporeflexia typically is seen soon after injury; autonomic hyperreflexia develops later below the level of spinal cord injury.