Question

Brianna went on to have a long and fulfilling career as a dancer. Unfortunately, at age 55, long after her dancing

            retirement, Brianna was in a bicycle accident. Upon arrival in the ED, she was conscious and complained of pain in her lower back. Upon examination, Brianna was found to have multiple abrasions and contusions, and loss of           motor control, although not sensation, of the legs. Her blood pressure and heart rate were both low. Once she       was stabilized, a complete neurological exam was performed and revealed normal stretch reflexes in the arms,   but no stretch reflexes in the legs. Two days later the exam was repeated. This time, Brianna displayed a plantar       reflex, although it was delayed and abnormal. Two weeks after the accident Brianna’s lower extremities were          hyperreflexive. By one month after the accident, her reflexes were normal, but motor control still had not   returned. At what level of Brianna’s spinal cord was her injury (cervical, thoracic, lumbar, or sacral)? What       region of the spinal cord or peripheral nerve was likely affected (gray matter horns, roots, spinal nerve, rami,           etc.)? What is your justification for this? Why has Brianna regained normal reflexes but not motor control in        her lower extremities? What is her prognosis for full recovery?

Answer 1

Answer: The injury mentioned above, appears to be at the lumbar level. The anterior rani is mainly affected. This also includes the L1- L4 where the spinal root is being divided into several cords. The injury in the spinal cord causes brain inflammation. This inflammation leads to loss of nerve cells. It causes cognitive impairment. The motor control is not yet regained because there is still lack of muscle contraction as well as tonic contraction. Hence this requires more time to develop co- ordination of muscles. The Prognosis of the spinal injury as it takes near about six to twelve months to develop proper functioning.