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NewYork-Presbyterian Hospital Psychiatry
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Case of the Month - August 2017

This 85 year old male was brought into the ED after he suffered a PEA arrest at home after he fell while getting dressed.

Question 1 : What’s wrong with these pictures?

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Answer 1:

There is marked anterolisthesis of C3 on C4 (arrow below) with bilateral jumped facets (circle below).

Question 2: What deficits would you expect to see in this patient if his spinal cord was damaged?
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Answer 2:

You would expect to see inability to breath and quadriplegia as the most notable deficits. The extent of this patient’s spinal cord involvement was not determined because the family deferred further workup and treatment given his age and comorbidities. It is still unclear if he had a mechanical fall which then caused his cardiac arrest or if he had a cardiac event first and then sustained his cervical injuries afterwards.

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