Pneumorrhachis Following Neck Penetrating Injury: A Case Report

Cureus, 2022 · DOI: 10.7759/cureus.31925 · Published: November 26, 2022

Simple Explanation

Pneumorrhachis (PNR) is a rare condition where air is found in the spinal canal. It's often discovered incidentally during imaging like CT scans. This report describes a case of a 27-year-old female who developed PNR after a penetrating neck injury from a stab wound. The patient experienced left-side body weakness and was found to have air in both the subdural and extradural spaces of the cervical spine.

Study Duration

Not specified

Participants

One 27-year-old female

Evidence Level

Level 4: Case Report

Key Findings

1
The patient presented with left-side body weakness after sustaining stab wounds to the neck and shoulder.
2
CT scan revealed intrathecal and extradural air foci in the cervical spine, along with a nondisplaced fracture.
3
MRI confirmed spinal cord injury at C3-C4 and C5-C6 levels, as well as defects in the ligamenta flava and posterior dura.

Research Summary

Pneumorrhachis (PNR) is an uncommon finding of air in the spinal canal, often asymptomatic and detected incidentally during imaging. Penetrating injuries are a rare cause of PNR, with most cases resulting from iatrogenic or blunt traumatic events. Although most cases are managed conservatively, it's crucial to differentiate between subdural and extradural air due to potential complications like pneumocephalus.

Practical Implications

Diagnostic Awareness

Clinicians should consider PNR in patients with penetrating neck injuries, even in the absence of obvious neurological symptoms.

Imaging Importance

CT scans are essential for identifying PNR, especially in trauma cases.

Conservative Management

Most PNR cases can be managed conservatively, but close monitoring is needed to detect potential complications.

Study Limitations

1
This is a single case report, limiting generalizability.
2
The patient was lost to follow-up, so the long-term outcome is unknown.
3
The study does not explore the detailed mechanism of air entry into the spinal canal in this specific case.

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