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. 2014:2014:870580.
doi: 10.1155/2014/870580. Epub 2014 Jun 26.

Expanding prevertebral soft tissue swelling subsequent to a motor vehicle collision

Matthew F Ryan  1 , David Meurer  1 , J Adrian Tyndall  1
Affiliations

Expanding prevertebral soft tissue swelling subsequent to a motor vehicle collision

Matthew F Ryan et al. Case Rep Emerg Med. 2014.

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.

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Figures

Figure 1
Figure 1
CT soft tissue of the neck without contrast showing prevertebral soft tissue swelling.
Figure 2
Figure 2
Lateral plain film taking in flexion demonstrating significant prevertebral soft tissue swelling with anterior tracheal displacement.
See this image and copyright information in PMC

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