TY - JOUR
T1 - Transient Hemiplegia in a Collegiate Ice Hockey Player
AU - Decker, Gregory
AU - Leo, Ashwin
N1 - Publisher Copyright:
© Wolters Kluwer Health, Inc. All rights reserved.
PY - 2022/6/1
Y1 - 2022/6/1
N2 - An otherwise healthy 21-yr-old female hockey player sustained a cervical whiplash injury during competition after being checked and falling backward onto the ice. Initial assessment revealed right-sided hemiparesis and sensory abnormalities. Magnetic resonance imaging and computed tomography of the brain and spine were unremarkable. Most of her right upper limb symptoms resolved in 24 hrs, with complete resolution in 5 days. Over 6 wks, she regained right lower limb strength with mild residual sensory deficits. Repeat magnetic resonance imaging of the cervical spine was unremarkable. At 18 wks, sensory symptoms resolved, with the exception of mildly decreased lower limb proprioception. The athlete was cleared to return to noncontact drills but not competition. The differential diagnosis included transient quadriplegia and/or hemiplegia ("cervical cord neuropraxia"), which typically resolves in 48 hrs, and incomplete spinal cord injury without radiographic abnormality, which is more likely to present with persistent symptoms. This case includes features of both diagnoses, making management challenging as return to play guidelines are nonspecific. Further research is needed to develop well-defined guidelines for spinal cord injury without radiographic abnormality and cervical cord neuropraxia return-to-play decisions.
AB - An otherwise healthy 21-yr-old female hockey player sustained a cervical whiplash injury during competition after being checked and falling backward onto the ice. Initial assessment revealed right-sided hemiparesis and sensory abnormalities. Magnetic resonance imaging and computed tomography of the brain and spine were unremarkable. Most of her right upper limb symptoms resolved in 24 hrs, with complete resolution in 5 days. Over 6 wks, she regained right lower limb strength with mild residual sensory deficits. Repeat magnetic resonance imaging of the cervical spine was unremarkable. At 18 wks, sensory symptoms resolved, with the exception of mildly decreased lower limb proprioception. The athlete was cleared to return to noncontact drills but not competition. The differential diagnosis included transient quadriplegia and/or hemiplegia ("cervical cord neuropraxia"), which typically resolves in 48 hrs, and incomplete spinal cord injury without radiographic abnormality, which is more likely to present with persistent symptoms. This case includes features of both diagnoses, making management challenging as return to play guidelines are nonspecific. Further research is needed to develop well-defined guidelines for spinal cord injury without radiographic abnormality and cervical cord neuropraxia return-to-play decisions.
KW - Cervical Cord Neuropraxia
KW - Spinal Cord Injury
KW - Sports Medicine
KW - Whiplash
UR - http://www.scopus.com/inward/record.url?scp=85130863456&partnerID=8YFLogxK
U2 - 10.1097/PHM.0000000000001979
DO - 10.1097/PHM.0000000000001979
M3 - Article
C2 - 35594409
AN - SCOPUS:85130863456
SN - 0894-9115
VL - 101
SP - E95-E97
JO - American Journal of Physical Medicine and Rehabilitation
JF - American Journal of Physical Medicine and Rehabilitation
IS - 6
ER -