Abstract
Cervical acceleration/deceleration or whiplash injuries are a common cause of cervical spine trauma. Cervical acceleration/deceleration can result in vertebral fractures, subluxations, and ligamentous and other soft tissue injuries. Severe injuries are often evidenced by increased prevertebral swelling on lateral X-ray. Assessment of the prevertebral space on lateral cervical spine films is an essential component for identifying potential traumatic neck injuries. We describe a case in which an 84-year-old man on coumadin presented to the emergency department after a low-impact motor vehicle crash. The patient initially complained of neck and shoulder pain which subsequently progressed to hoarseness, dysphagia, and dyspnea. Imaging studies revealed significant prevertebral tissue swelling with anterior compression of his airway that required airway stabilization via awake fiber-optic intubation and reversal of his anticoagulation therapy.
Highlights
Cervical spine injuries occur in approximately 3.7% of all trauma patients [1]
We describe a case of an 84-year-old man who developed large prevertebral tissue swelling after an motor vehicle collision (MVC)
The cause of the prevertebral swelling in this case is thought to be secondary to a whiplash-like injury compounded by the fact that the patient was on a blood thinner and was of advanced age
Summary
Cervical spine injuries occur in approximately 3.7% of all trauma patients [1]. The injuries are associated with high morbidity and mortality stemming from injuries to the spinal cord and cervical vasculature. A common mechanism of injury is the result of cervical acceleration/deceleration secondary to a blunt impact of such a motor vehicle collision (MVC). This mechanism results in rapid extension of the head followed by forward flexion [2]. A rare consequence of cervical spine injuries is the development of a prevertebral hematoma with associated prevertebral soft tissue swelling. These injuries can lead to rapid airway compromise as a result of significant anterior widening of the retropharyngeal space secondary to edema and the development of a hematoma [3]. Confounding the case, the patient was on coumadin for atrial fibrillation which needed reversal by using prothrombin complex concentrates (PCC)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
