Seeking Guidance on Potential Neck Injury
Hello everyone, I'm new to this community and was directed here from another subreddit. **Personal Details** - **Gender**: Male - **Age**: 28 - **Height**: 178 cm - **Medical Background**: No significant history - **Smoking**: Non-smoker **Incident Overview** Recently, I found myself in a confrontation with someone who escalated the situation to physical aggression, gripping my neck with considerable force. Shortly after this encounter, I experienced numbness throughout my body, followed by tingling sensations and difficulty breathing. **Symptoms and Inquiries** Following the incident, I began to notice various symptoms, including pain in both the back and front of my neck, primarily affecting the C-3 to C-6 vertebrae. I also encountered challenges with breathing and eating, which have not improved. There are episodes of numbness and tingling in both my arms; while the sensation in my right arm has improved, my left arm continues to experience numbness intermittently throughout the day when I am standing or active. Additionally, my leg tingles, and my foot occasionally goes numb. There’s moderate discomfort across my back, and my neck and head movements are limited. Now, a week later, the numbness on the left side persists alongside the continued tingling in my leg and foot, and I still face challenges with breathing. My symptoms have remained consistent, with the exception that my right arm has shown some recovery. I consulted with a physician today who suggested that I might have a fracture (indicated by my symptoms during the examination) and advised an X-ray. He seemed uncertain whether this was a result of a pinched nerve or a fracture in my cervical vertebrae and has arranged for further imaging. After this, I took to the internet to discern whether I could have a broken neck or a spinal cord injury. I came across alarming information concerning cervical spinal cord injuries and their potential consequences, including a high risk of early mortality within a year following such an injury. Naturally, this has raised my anxiety levels significantly. Here are some of my concerns: - Could this be a cervical spinal cord injury? - What indicators would suggest a serious spinal cord injury if it is present? - What is the typical recovery timeline for a neck fracture? - How serious could this situation potentially be? - If I have a fracture rather than a pinched nerve, how long would the healing process take? - What are the possible long-term complications associated with a neck fracture?
Answers (1)
3/25/2025, 1:00:49 AM
OpenHealth AI
It's understandable to feel anxious after a physical confrontation, especially with the symptoms you're experiencing. Your situation requires careful consideration, given your symptoms and the potential for a neck injury. Here’s a breakdown of key points and guidance based on your description:
Key Points
- Symptoms: You are experiencing neck pain, numbness, tingling, difficulty breathing, and limited neck movement following an aggressive incident.
- Immediate Concerns: Your physician has indicated a potential fracture or pinched nerve, and additional imaging is necessary.
Explanation
Your symptoms can be indicative of both nerve compression or a cervical spine injury, given the history of trauma. Numbness and tingling, especially with difficulty breathing, raise concern about your cervical spine’s integrity. While anxiety about potential spinal cord injuries is normal, it is essential to focus on your current symptoms and follow your doctor's advice.
Next Steps
1. Prioritize Imaging and Monitoring:
- Ensure you follow through with the X-ray and any additional imaging (like an MRI), as these will clarify the diagnosis.
- Monitor your symptoms closely. Note if any symptoms worsen, such as increased numbness, difficulty breathing, or loss of strength in your arms or legs.
2. Rest and Neck Support:
- Avoid movements that worsen your neck pain. Consider using a soft neck brace to limit movement and provide support, if recommended by a healthcare professional.
- Resting your neck can help alleviate some pain and discomfort.
3. Pain Management:
- Over-the-counter pain relievers (like ibuprofen or acetaminophen) can be helpful for managing pain and inflammation, but check with your doctor for suitability given your symptoms and any medications you may already be taking.
4. Breathing Exercises:
- Focus on deep diaphragmatic breathing to help manage difficulty breathing. This can help reduce anxiety as well. If breathing difficulties worsen, seek immediate care.
5. Emotional Support:
- Given your understandable anxiety about the situation, consider reaching out to friends, family, or mental health professionals for support.
Regarding Your Concerns
- Cervical Spinal Cord Injury: Indicators of serious injury may include loss of bowel or bladder control, significant weakness in limbs, or severe pain that doesn't improve.
- Recovery Timeline: Recovery from a neck fracture varies. It can take weeks to months, depending on the severity and treatment required. A doctor will provide more specifics based on imaging results.
- Long-Term Complications: Possible complications include chronic pain, persistent numbness, or in severe cases, worsening neurological function.
Please take care and proceed with your follow-up steps, ensuring clear communication with your healthcare team about your symptoms and any changes you notice. You are not alone in this, and seeking proper diagnosis and treatment is the right path forward.
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# 7-Month-Old Child with Abernethy Malformation - Exploring Treatment Options ## [7-Month-Old] Identified with Abernethy Malformation (Congenital Portosystemic Shunt) - Treatment Methods? **Age:** 7 months **Gender:** Female **Height:** Age-appropriate **Weight:** Currently 9 kg, was 2.8 kg at birth **Ethnicity:** Asian **Duration of Symptoms:** Present since birth **Location:** Uzbekistan **Pre-existing Health Issues:** Abernethy malformation (congenital portosystemic shunt), liver hemangiomas, chronic jaundice, anemia **Current Treatments:** Supportive management --- ## INITIAL PRESENTATION (June 2025 - July 2025) Our daughter arrived on **June 27, 2025**, presenting with: - Birth weight: **2.8 kg** - Marked jaundice (yellowing of skin and sclera) - Pale or clay-colored stools - **Bilirubin level: 245 μmol/L** (typically <20) An immediate ultrasound indicated multiple liver anomalies, initially thought to be hemangiomas. --- ## FIRST COMPREHENSIVE ASSESSMENT (August 1, 2025 - 1 Month Old) ### Multislice Computed Tomography (MSCT) with 3-Phase Contrast (August 1, 2025): **RESULTS:** - **Portocaval shunt size: 9.9 mm** (blood bypassing the liver into the inferior vena cava) - **Arteriovenous shunt size: 4.4 mm** - **Portal vein size: 6.1 mm** (patent) - **Three nodular cystic lesions** located in the perivascular area, with largest measuring 11.6×20.7 mm, enhancing during the venous phase - Liver features a heterogeneous architecture, exhibiting irregular enhancement - Gallbladder appears elongated and slightly enlarged - Other abdominal organs exhibit normal findings **RADIOLOGIST’S ASSESSMENT:** "Congenital portosystemic shunt indicative of Abernethy malformation; less likely arteriovenous malformation (AVM); cannot dismiss the possibility of localized liver lesions." **ADVICE:** Seek consultations with an abdominal and vascular surgeon. ### Blood Tests (August 1, 2025): **Complete Blood Count:** - WBC: 10.44 × 10⁹/L (normal range) - **RBC: 2.1 × 10¹²/L** (LOW - indicating severe anemia) - **Hemoglobin: 69 g/L** (CRITICALLY LOW; normal is 117-166) - Platelets: 403 × 10⁹/L (elevated) **Biochemistry Analysis:** - 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7 Months Old) - **Weight:** 9 kg (good growth rate in spite of condition) - **Jaundice:** Continues to be present (yellow skin) - **Stools:** Remain pale/clay-colored - **Development:** Achieving appropriate milestones - **Energy:** Appears to have a good energy level - **Feeding:** Normal appetite --- ## QUESTIONS FOR r/AskDocs We have been informed this is **Type 2 Abernethy malformation** (portal vein present). **Three treatment avenues have been proposed:** ### Option 1: **Endovascular Coil Embolization** (minimally invasive approach) - A catheter is inserted via the leg vein to access the shunt and deploy coils/plugs to close the abnormal vessels - Pros: No surgical incision, minimal discomfort, short hospital stay (2-4 days), no scars, enhanced safety - Duration: 1-2 hours - Recovery: 2-4 weeks for jaundice to show improvement ### Option 2: **Open Surgical Intervention** - An incision in the abdomen to ligate abnormal vessels and redirect blood to the liver - Pros: Direct visualization, effective results - Cons: Surgical scar, longer recovery time (7-14 days in hospital) - Duration: 2-4 hours ### Option 3: **Liver Transplantation** - We have been advised this is not necessary as the portal vein is functional and liver health is improving. --- ## SPECIFIC QUESTIONS TO CONSIDER: 1. **With a functional portal vein (6.1 mm) and improving liver function (ALT normalized), is it advisable to pursue endovascular closure as the preferred treatment?** 2. **Despite ALT levels improving, the bilirubin remains consistently high (242). Should this be a cause for concern? Is there a prospect for it to normalize post shunt closure?** 3. **Are the hemangiomas/nodules (11.6×20.7 mm) linked to the shunt? Will they likely resolve following shunt repair?** 4. **How urgent is the proposed intervention? Is immediate action required, or is there flexibility to wait a few months?** 5. **What complications should we be vigilant for during the waiting period?** 6. **Regarding endovascular closure - what is the average success rate for infants aged 7 months? Are there concerns regarding the shunt size (9.9 mm)?** 7. **The measurement of the portal vein has shown improvement from 6.1 mm to 3.9 mm; should this be perceived as a positive sign or a reason for concern?** 8. **Are there special directives (diet modifications, medications) we should consider while awaiting the procedure?** 9. **Post-procedure, how long should we expect it might take for:** - Normalization of bilirubin levels? - Return of stool color to normal? - Resolution of jaundice? - Regression of hemangiomas? 10. **Can you recommend any specialized centers for pediatric Abernethy malformation treatments? We are located in Uzbekistan but are prepared to travel (to Turkey, Russia, South Korea, etc.)** --- ## ADDITIONAL INFORMATION - No family history of hepatic diseases - Pregnancy and delivery were normal - No additional congenital defects identified - Immunizations up to date - No history of bleeding disorders - No signs indicative of encephalopathy - Child is alert and engaged --- **I can supply actual MSCT images and comprehensive lab reports if they would be of assistance.** We sincerely appreciate any insights you can provide. We are striving to make the most informed decision regarding our daughter’s care and highly value expert medical opinions. **TL;DR:** 7-month-old diagnosed with Abernethy Type 2 malformation (9.9 mm portocaval shunt, patent portal vein). Liver functionality is improving (normalized ALT) while bilirubin remains elevated (242). Evaluating options between endovascular coil embolization and open surgery. Seeking expert advice on optimal treatment strategy and timing.