We would like to graciously acknowledge Gary Linassi, MB FRCPC for his contribution to the development of this case study.
Ms. MB is a 67 year old female who had onset of numbness and tingling in both shoulders over the course of one year. Bowel and bladder dysfunction, in addition to altered gait and weakness of her hands prompted subsequent investigation. Investigations identified a large meningioma compressing the cord at the C4 level; however, neurosurgery to decompress the area and remove the meningoma was unsuccessful. Postoperatively, the patient was left with a C4 AIS A spinal cord injury. See figure 1 and 2 for Ms. MB’s health status.
Figure 1. Ms. MB's presenting condition.
Figure 2. C4 AIS A spinal injury. From Medical Illustration 2010, Nucleus Medical Media, Inc. Patient has upper and lower extremity paralysis, respiratory dysfunction including sleep apnea and respiratory secretion accumulation.