Penetrating spinal cord injury causing paraplegia in a bird hunter in rural Tanzania

Spinal Cord Series and Cases, 2019 · DOI: https://doi.org/10.1038/s41394-019-0195-7 · Published: May 5, 2019

Spinal Cord Injury Trauma Rehabilitation

Simple Explanation

This case report describes a 17-year-old male in rural Tanzania who sustained a spinal cord injury from a penetrating neck wound while bird hunting, resulting in paraplegia. The patient's injury highlights the unique challenges of managing spinal cord injuries in low-resource settings, including delayed access to care, limited imaging capabilities, and transportation issues. Despite these challenges, the patient received comprehensive rehabilitation services, including physiotherapy, occupational therapy, and bladder/bowel management, demonstrating the dedication of healthcare professionals in the region.

Study Duration

Not specified

Participants

1 patient: 17-year-old male bird hunter

Evidence Level

Level 4: Case Report

Key Findings

1
The patient sustained an incomplete spinal cord injury at the T3 level following a penetrating neck injury corresponding to the C5 level from an arrow.
2
MRI imaging revealed extensive signal abnormality in the spinal cord, extending from the inferior level of C7 to the superior level of T1, with cerebrospinal fluid replacement.
3
Despite initial paralysis, the patient demonstrated gradual, albeit patchy, return of sensation on the right side of the body, highlighting the potential for neurological recovery.

Research Summary

This case report details a rare instance of traumatic spinal cord injury (TSCI) resulting from a penetrating neck wound sustained during bird hunting in rural Tanzania. The report highlights the challenges in managing such injuries in low-resource settings, including delayed presentation, limited access to imaging and specialized care, and logistical issues with patient transport. Despite these challenges, the patient received multidisciplinary care and rehabilitation, leading to some neurological improvement and improved functional independence.

Practical Implications

Injury Prevention

Increased public awareness and education on injury prevention strategies, particularly in rural communities, could reduce the incidence of TSCIs.

Resource Allocation

Investment in healthcare infrastructure, including imaging equipment and rehabilitation services, is crucial for improving outcomes for TSCI patients in low-resource settings.

Pre-hospital Care

Training of community members and healthcare providers on proper pre-hospital management and transportation of trauma patients could minimize secondary injuries and improve patient outcomes.

Study Limitations

1
The study is a single case report, limiting generalizability to other populations or settings.
2
Delayed imaging may have affected the accuracy of diagnosis and treatment planning.
3
Follow-up data is limited, making it difficult to assess the long-term outcomes of the patient's rehabilitation.

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