CLINICAL HISTORY 8

A 45-year-old electrician Kent Renou fell 3 meters on January 5 and was unconscious for 15 minutes. He was found by his neighbours and wife and admitted to the hospital where after regaining consciousness, he complained of pain in both shoulders and neck and of numbness of the second and third fingers of the right hand. He was noted to have limitation of neck motion. A cervical spine roentgenogram, taken at the time of his admission, included only five upper vertebrae. A complete roentgenographic series of the cervical spine taken the next day was normal. He was treated by physiotherapy and discharged several days later.

His complaints persisted and two months later a consultation revealed a tilt of his head to the right, limitation and diffuse tenderness of the posterior neck muscles. The right triceps reflex was absent with hypoesthesia to pin prick over the second and third fingers of the right hand. A lateral cervical X-ray film demonstrated a first-degree delayed traumatic dislocation of the cervical spine. An anterior cervical disk-ectomy and reduction of the cervical vertebrae were performed. The patient did well and was asymptomatic ten months later with roentgenographic evidence.

CLINICAL HISTORY 9

A 3-year-old girl Marisha Pishka with a history of mild motor delay was presented with a change in mental status, gait difficulties, nausea and vomiting. The patient was in her usual state of health until 9 months prior to presentation, when she was found to have abnormalities of the left eye. Over the next several months, she developed gait difficulties and behavioral changes. On the day of admission, she developed confusion, severe gait difficulties, nausea and profuse vomiting. On physical examination, she had increased deep tendon reflexes of her right Achilles tendon. She subsequently became unresponsive. She was intubated and given mannitol and steroids. An external ventricular drain was placed. Neuroimaging showed a minimally heterogeneous tumor measuring 8×8×9 cm involving the left parietal region and, partly filling the left lateral ventricle. Gross total resection of the tumor was confirmed by post-operative imaging. Staging evaluation revealed no metastasis. The patient was discharged one week later.

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CLINICAL HISTORY 5	\|	CLINICAL HISTORY 10

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