injuries and poisoning
Spinal Cord Injury in Children
Introduction
A spinal cord injury is damage to the bundle of cells and nerves that carry incoming and outgoing messages between the brain and the rest of the body. Most spinal cord injuries in children younger than 8 years result from motor vehicle crashes, falls, and child abuse; spinal cord injuries in older children are more likely to result from motor vehicle crashes or sports injuries. A child with a spinal cord injury may have severe symptoms (such as paralysis), usually immediately. A child with a spinal cord injury may only have mild symptoms (such as brief tingling or weakness or shooting pains down the spine or arms and legs), and those symptoms may be delayed up to 4 days. Diagnosis of a spinal cord injury begins with an x-ray, but computed tomography (CT) and magnetic resonance imaging (MRI) are usually also needed. Treatment involves mobilization and supportive care, with rehabilitation and other treatments as needed. (See also Injuries of the Spinal Cord and Vertebrae .) The spinal cord is a long, fragile tubelike structure that begins at the end of the brain stem and continues down to the lower part of the spine. The spinal cord consists of nerves that carry incoming and outgoing messages between the brain and the rest of the body. (See also Spinal Cord .) Although children younger than 10 years have the lowest rate of spinal cord injuries, such injuries are not rare. Most spinal injuries in children occur in the neck area. Spinal cord injury that is not visible on imaging tests is called "spinal cord injury without radiologic abnormality" (SCIWORA). This type of injury occurs almost exclusively in children and often occurs in the neck area. In SCIWORA, the child has symptoms that suggest a spinal cord injury, but the spinal column is straight and no bone abnormalities are seen on imaging studies. (SCIWORA was originally described in the 1980s, when magnetic resonance imaging [MRI] scanners were scarcely used. MRI scanners identify most abnormalities that would not have been identified using other imaging tests. Because MRI scanners are more readily available, the term SCIWORA is used less commonly.) 