Dual lesion spinal cord injury in a polytrauma patient: a case report

Abstract

Introduction: Dual lesion spinal cord injury (SCI) is the presence of two distinct regions of injury to the spinal cord, which can occur simultaneously or as a sequela of initial injury. Dual lesion SCI appears to be a rather rare occurrence with a paucity of cases described. As such, there is limited information available regarding presentation, evaluation, long-term rehabilitation management, and prognostication of these patients. Case presentation: Presented is a case of a 25-year-old woman with a gunshot wound injury to the T5 vertebra with associated cord damage, initially classified as T6 ASIA Impairment Scale (AIS) B. A subsequent cervical spinal stroke, in the setting of cord edema, resulted in a motor incomplete cervical SCI. As such, she underwent additional functional decline. Discussion: Patients with dual lesion SCI present with unique challenges in evaluation and management. This case highlights key factors for the acute care and rehabilitation teams to consider when addressing these challenges.