Questions about spinal Contusions/lesions

[KayakFun]

Hi all! Sorry, this is long. I had a very bad accident back in 06 involving a staircase, no banister, and going through a wall. I fell from a standing position, and rotated backwards. I blacked out and woke up after the wall I went through bounced me back and down on the landing.

I could not feel anything from neck down and I could not will anything to move. I looked at my body parts and they were a jumbled mess that looked like a broken pretzel. Had a huge pain in my neck and all my body weight was on it. I screamed for someone to pull me up.

I just knew I had to get the pressure off my neck. Once I was lifted. I could move everything, and now feel the parts that were broken. Felt like I broke my neck, shoulder, and arm.

Broke my right arm, ER hospital missed compression fx of C6-C7 T3,4,6 and injury to L5-S1. No steroids or anything else.

Bone density was fine for my age and MRI shows compression fx recent. Was actively exercisng 3 to 4 times per week ( jazzercize) which I think is why my neck did not break completely.

Now the interesting part. When the swelling went down, I could get a cast. The home ortho looked at my x-rays and saw a fx of C6 and sent me for MRI. Right away I get a call to go back and get it with contrast. Then I am told I need a neuro. Neuro says No MS I am too healthy. He did not tell me it was spinal contusions in his opinion b/c of faint signals. I did not know contusions appear as lesions. They were at C6 and C2. He said my skull probably hit my spine at C2.

Ok. Good. Another opinion says I broke the top of C7 and reversed the curve or my neck. Meanwhile I try to go off muscle relaxers during the night. No way. Things just started moving all over the place every 10 to 30 seconds. Never had this before accident.

Of course I am on pain meds almost 24/7 except to drive as little as possible. Try standing up more and that is when I realized I had problems with my right leg. PT, epidurals, discogram, ALIF.

Another MRI of neck shows I have smaller faint lesions at C3 C4 now. Then they do brain. One large one on the side that hit the wall and 4 small little things opposite it. Now they are saying I should exclude MS. One O band +, but no hx. Started me on DMD anyway.

So ok, I am dealing and doing the forums for MS, learning about lesions and googling, now that my pain is better and my head is clearer. I am reading through my records and I realize that the MS doctors never saw the notes from the first neuro. They are thinking any lesions = MS. Who's right?

Now I understand blunt force trauma can tear at brain tissues = lesions and contusions = lesions, and that O bands are produced when this stuff happens. Also that steroids help avoid further damage from the initial damage "repair" immune responders, and if you don't get them further damage can happen from the immune responders.

I think I need some kind of spinal/brain trauma specialist to sort this out. I am off DMD. Made me too sick. Do I have MS, MS + spinal/brain injury, or just trauma injuries? Its a puzzle to me.

[Sue Pendleton]

Moved the above post, number 2, to a seperate thread.

[Sue Pendleton]

Welcome Kayak,

You could see a neurologist, neurosurgeon or possibly a physiatrist who would coordinate the other docs while arranging pain and spasm control meds. There is a sub-type of TM often called spinal MS. You'd show lesions over time that would multiply. This would not account for your brain lesions. Recurring TM is not quite the same but that particular kink is past my understanding. Sounds like you need to deal with any fractures not currently stabilized then get a yes or no on the MS so you can begin the appropriate teatment.

I'll ask Dr Young to read in on this but I think he'll need more information also.

[Wise Young]

Hi all! Sorry, this is long. I had a very bad accident back in 06 involving a staircase, no banister, and going through a wall. I fell from a standing position, and rotated backwards. I blacked out and woke up after the wall I went through bounced me back and down on the landing.

I could not feel anything from neck down and I could not will anything to move. I looked at my body parts and they were a jumbled mess that looked like a broken pretzel. Had a huge pain in my neck and all my body weight was on it. I screamed for someone to pull me up.

I just knew I had to get the pressure off my neck. Once I was lifted. I could move everything, and now feel the parts that were broken. Felt like I broke my neck, shoulder, and arm.

Broke my right arm, ER hospital missed compression fx of C6-C7 T3,4,6 and injury to L5-S1. No steroids or anything else.

Bone density was fine for my age and MRI shows compression fx recent. Was actively exercisng 3 to 4 times per week ( jazzercize) which I think is why my neck did not break completely.

Now the interesting part. When the swelling went down, I could get a cast. The home ortho looked at my x-rays and saw a fx of C6 and sent me for MRI. Right away I get a call to go back and get it with contrast. Then I am told I need a neuro. Neuro says No MS I am too healthy. He did not tell me it was spinal contusions in his opinion b/c of faint signals. I did not know contusions appear as lesions. They were at C6 and C2. He said my skull probably hit my spine at C2.

Ok. Good. Another opinion says I broke the top of C7 and reversed the curve or my neck. Meanwhile I try to go off muscle relaxers during the night. No way. Things just started moving all over the place every 10 to 30 seconds. Never had this before accident.

Of course I am on pain meds almost 24/7 except to drive as little as possible. Try standing up more and that is when I realized I had problems with my right leg. PT, epidurals, discogram, ALIF.

Another MRI of neck shows I have smaller faint lesions at C3 C4 now. Then they do brain. One large one on the side that hit the wall and 4 small little things opposite it. Now they are saying I should exclude MS. One O band +, but no hx. Started me on DMD anyway.

So ok, I am dealing and doing the forums for MS, learning about lesions and googling, now that my pain is better and my head is clearer. I am reading through my records and I realize that the MS doctors never saw the notes from the first neuro. They are thinking any lesions = MS. Who's right?

Now I understand blunt force trauma can tear at brain tissues = lesions and contusions = lesions, and that O bands are produced when this stuff happens. Also that steroids help avoid further damage from the initial damage "repair" immune responders, and if you don't get them further damage can happen from the immune responders.

I think I need some kind of spinal/brain trauma specialist to sort this out. I am off DMD. Made me too sick. Do I have MS, MS + spinal/brain injury, or just trauma injuries? Its a puzzle to me.

I think that the evidence that you describe does not convincingly show that you have MS versus combined mild head and incomplete spinal cord injury from your accident in 2006. I am shocked that they did not do an MRI of your brain and spinal cord from the beginning given your history of unconsciousness and paralysis. The only argument for MS would be if you have had new lesions since your accident in 2006. If there are, you should not assume MS.

One possible test that you might want to repeat is CSF antibodies again. Note that after brain and spinal cord injury, there will be antibodies in the CSF due to breakdown of the blood brain barrier. They should be gone now. If you have clear CSF now, that would be another argument against MS.

Wise.

[KayakFun]

Thank you for moving my post Sue!

Thank you Dr. Wise. I am not convinced I have MS either. I could do another LP because the first one was done with a new thin needle and it was not a bad experience. Before I do that, I will get a review done of my MRIs, now that they can be looked at in retrospect.

I was taken to the hospital by car not ambulance. I now know had they put a head fixture on me, since I had a reversed curve, I could have been more seriously injured.

I was in so much pain and probably in shock. The ice melted and my right arm swelled so bad they had to cut a ring off ASAP. I did not think to tell them I passed out or that I was numb from the neck down at the bottom of the staircase.

They did not ask me about how I fell or if I passed out, or if I had any neurological issues from the fall.

They missed the fx of C6 on the xray and did not even get C7 on the xray. I was 4 hours from home, and out of state. I think they wanted to do the bare minimum and get me out the door.

Recently, I had some numbness in my right foot with a few toes and the very forefront of my foot, and my podiatrist tells me this happens with hammer toes. It is worse in the morning and fades as the day goes on. I was thinking this was an MS thing.

I am getting 3/4 orthodics to see if it helps.

Thank you so much Sue and Dr. Wise for sponsoring this fourm. It is not easy to find information on incomplete spinal cord injury when you only have mild issues.