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Introduction
This 40 year old woman was the intoxicated
driver of a car which hit a tree at 80 km/hr. Impact
was head on, and both driver and passenger were wearing
seatbelts at the time of impact. The passenger was taken
to the local hospital where she had abdominal injuries.
The driver was seen at the local hospital and transfered to your
trauma centre.
When she arrives, she is on a long spine
board and a semirigid cervical collar is on. She is able
to turn her head while in the collar, and is somewhat
agitated. She complains of "a little neck pain"
and appears to be slurring her words.
CT scan of her head is normal, and her
blood alcohol level is elevated. Neurologic examination
reveals mild weakness of elbow flexion and extension on the left
side, associated with decreased sensitivity to
two-point-discrimination over the left lateral forearm.
Radiographs are shown below.
Radiographs of the C-spine
What is the diagnosis ?
Does it explain the neurologic findings?
How would you treat this patient:
A: In the trauma room ?
B: Definitively ?
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