[Severe dyspnea by combination of cervical spondylosis and struma].
In: Deutsche medizinische Wochenschrift (1946), Jg. 140 (2015-05-01), Heft 11, S. 824-6
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Zugriff:
Unlabelled: CASE HISTORY PHYSICAL EXAMINATION: A 79-years-old female suffered from cervical pain for several years which radiated in both shoulders. A nodular goiter was already known and therefore a radio iodine treatment had been planned. Eight months ago the patient noticed a progressing breathlessness. Emergency admission happened due to inspiratory stridor and severe attacks of dyspnoea. Sufficient breathing was only possible by wearing a rigid cervical collar. There were no neurological deficits.
Examination: Tracheoscopy showed a mass in the dorsal cervical region. The cervical x-ray, computed tomography and magnet resonance imaging conformed a distinct spondylopathy at the leading edge of the cervical vertebral bodies including ventralisation of the oesophagus and narrowing of the trachea (>50%).
Therapy and Course: Simultaneously a total thyroidectomy, including neuromonitoring of the N. vagus, and ventral microsurgical resection of the spondylopathy was performed. There was no relapse of dyspnoea in the following year.
Conclusion: The coincidence of a goiter and ventral cervical spondylopathy accompanied by significant dyspnoea is remarkable. The order of diagnostic steps in this emergency case displays a major problem. The patient was scheduled for goiter surgery and admitted as emergency due to a stridor. The cervical spondylopathy was diagnosed by tracheoscopy and cervical x-ray. This case report emphasizes the importance to think about cervical lesions in the presence of a goiter and dyspnoea. To find out quickly whether there is a cervical lesion or not a x-ray should be obtained. Missing these lesions can result in a fatal course.
(© Georg Thieme Verlag KG Stuttgart · New York.)
Titel: |
[Severe dyspnea by combination of cervical spondylosis and struma].
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Autor/in / Beteiligte Person: | Woischneck, D ; Eder, A ; Holstege, A ; Kapapa, T ; Scher, B ; Schütze, M ; Blumstein, N |
Zeitschrift: | Deutsche medizinische Wochenschrift (1946), Jg. 140 (2015-05-01), Heft 11, S. 824-6 |
Veröffentlichung: | Stuttgart [etc.] : G. Thieme, 1946-, 2015 |
Medientyp: | academicJournal |
ISSN: | 1439-4413 (electronic) |
DOI: | 10.1055/s-0041-102524 |
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