The head was gently stabbed, why was it paralyzed?

Lao Zhang was 72 years old, his eyes were not spent, his ears were not deaf, his body was tough, and his spirit was stubborn. Two days ago, I accidentally fell at home, but my head was gently stumped. The words were fluent and sober, but I felt weak at the time, I couldn't lift my arms, I couldn't stretch my legs, and I couldn't stand up. At the same time, I couldn't stand up. At the same time, I couldn't stand. I also feel that the arms on both sides have obvious skin tingling sensation. The family immediately sent Lao Zhang to the emergency department of the hospital.

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Because the head injury caused the limbs to move, the family members felt that Lao Zhang must have a problem with his mind, and he directly hung the emergency number of neurosurgery. However, after the doctor's physical examination, there are also routine examinations such as head CT and MRI ("MRI often called" MRI "), and everything is normal! This is strange: Since the arms and legs can't move, it must be a problem with the brain, but the results of the brain examination are not different. What is going on?

At this time, the suggestion of the neurologist is to look at orthopedics. After coming to the orthopedic emergency department, after the doctor's examination, the family's talents understood that the original head damage was not a big deal, and the problem was the cervical spine!

The name of this damage in medicine is "fracture -free dislocation cervical spinal cord injury". As the name suggests, the patient's neck has no fracture and no joint dislocation, but a problem with the neck spinal cord. This disease is a type of cervical spinal injury, and often has a certain pathological basis, such as congenital, developing or degenerative cervical spine spine stenosis, or unstable cervical spine, abnormal cervical development, acute or detached cervical discs, etc. Essence

Under normal circumstances, there will be a lumen formed by the vertebral and vertebrae of the vertebrae of the vertebrae of the human body. Each vertebra is connected to the spinal canal, and the spinal cord is passed. The neck spinal cord is "in charge" with the feeling and movement of the limbs.

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If the patient has the pathological state mentioned earlier, the severe lumen means that the spinal cord will be oppressed at any time. In the case of external forces (such as head trauma), the neck spinal cord can edema and hematoma, resulting in the original narrow cervical vertebral vertebral cavity. At this time, the edema's spinal cord will be more severe Or dysfunction. In this state, the patient's cervical spine X -ray or CT examination only shows the cervical vertebral alleged stenosis without any manifestations of cervical fracture or dislocation.

From the two images below, you can clearly see what kind of performance will be after the cervical vertebrae is narrow and the neck spinal cord is obviously compressed.

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This situation is more common in middle -aged and elderly people with abnormal cervical spine. Although these patients have narrow cervical vertebrae and the spinal cord pressure has obviously existed, there are often no symptoms and no obvious discomfort. Know. This is actually very dangerous! Because the cervical vertebrae is narrow, the cervical spinal cord is lost in the free "activity" space in the spinal canal (don't underestimate this space, it can cushion the external force, protect the spinal cord, the smaller the space, the less effective the space can be cushioned), and the external force is slightly external force. It will cause the spinal cord to be directly impacted, and in severe cases, it can cause the limbs to be paralyzed. Such damage external forces are usually mild, and many people have not even noticed that they have suffered from cervical trauma.

It is self -evident: a small external force becomes "the last straw of the camel"!

It is also paralysis of limbs. How to distinguish between neck spinal cord injury or brain injury? In fact, the identification is very simple: if the limbs are paralyzed after the brain trauma, patients are often accompanied by conscious disorders, and there will be no pain in the limbs. Patients with spinal cord injury often have a clear mind and will not be accompanied by conscious disorder, but they will be accompanied The skin of the limbs and trunk is tingling, and the upper limbs are often heavy than the lower limbs. Of course, nuclear magnetic examinations are also needed to further clarify the diagnosis.

For patients with "fracture -free deserture -free cervical spinal cord damage", it is recommended to actively surgical treatment. The purpose of surgery is to expand the spinal canal cavity, reduce spinal cord compression, and create a space that allows the spinal cord to "recover function". In theory, the sooner the surgery, the better.

Successive diseases are often multi -segmental spinal tube stenosis. Doctors will first recommend that "the rear -lapse of the dorsal spinal canal expansion of the neck road" (in popular point, it is to operate around the neck and use steel plates, screws and other instruments to allow equipment to allow equipment to allow equipment to allow equipment to allow equipment to allow equipment to allow equipment to allow equipment to allow equipment to allow equipment to allow equipment to allow equipment to allow equipment to allow equipment. The spinal canal cavity that was originally narrowed); depending on the pressure of the spinal cord, you can also choose the front surgery (that is, the surgery in front of the neck); Joint surgery.

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"Fractive dislocation of cervical spinal cord damage" has great hidden dangers. It is recommended that middle -aged and elderly people can do a cervical spine line test when healthy testing. If the cervical spine degeneration is obvious or the cervical spondylus stenosis is found, it is best to do the cervical diamond magnetic examination. If the problem is found to be treated in time, you can prevent problems before!

Author ｜ Han Liqiang Tianjin Third Central Hospital, Deputy Chief Physician

Review ｜ Guo Shuzhang Tianjin Third Central Hospital, chief physician

Source: Chinese Medical Association

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