Spinal cord injury caused by stab wounds after a penetrating trauma: About 2 cases

• hana kessentini

  hopital habib bourguiba service des urgences

• Dr Rim Karray

  Hopital Universitaire Habib Bourguiba

• Dr Fedi Ben ali

  Hopital Universitaire Habib Bourguiba

• Dr Haifa Snoussi

  hopital régional de mahres

• Dr Marwa Belalkhal

  Hopital Universitaire Habib Bourguiba

• Dr Olfa Chakroun

  Hopital Universitaire Habib Bourguiba

• Dr Noureddine Rekik

  Hopital Universitaire Habib Bourguiba

Background:
Penetrating spinal cord injury caused by stab wounds is rare but represents a distinct clinical entity within traumatic spinal cord injuries. Non-missile penetrating injuries account for a small proportion of spinal trauma, most often occurring in the context of interpersonal violence. Their management remains challenging due to limited clinician experience and the absence of clear treatment guidelines. In addition to immediate neural damage, these injuries may result in delayed complications such as infection, cerebrospinal fluid leakage, and chronic neuropathic pain.

Case presentation:
We report two cases of cervical spinal cord injury caused by stab wounds without associated vertebral fracture or dislocation.
The first patient, a 50-year-old woman, presented with complete tetraplegia following a cervical stab wound. Imaging showed a transverse spinal cord contusion with hemorrhagic edema at C4. Despite conservative management including immobilization, prophylaxis, and corticosteroid therapy, neurological status remained unchanged at three months.
The second patient, her daughter, sustained a lateral cervical stab wound and presented with right hemiparesis. MRI demonstrated an incomplete spinal cord transection at C5–C6. She was treated conservatively with corticosteroids and rehabilitation, resulting in slight neurological improvement at three-month follow-up.

Conclusion:
Spinal cord injury caused by stab wounds is uncommon but potentially devastating. MRI plays a central role in diagnosis and prognostic evaluation. In the absence of compressive lesions or foreign bodies, conservative management with close neurological monitoring remains an appropriate strategy.

• PDF

Copyright (c) 2026 Tunisian Journal of Emergency Medicine

This work is licensed under a Creative Commons Attribution 4.0 International License.

THE tjem allows authors to retain unrestricted copyright and full publishing rights of their articles.

All articles published in this journal are openly accessible and licensed under the Creative Commons Attribution 4.0 International License (CC BY 4.0). This guarantees that anyone is free to:

• Share: Copy and redistribute the material in any medium or format.

• Adapt: Remix, transform, and build upon the material for any purpose, even commercially.

Under the following terms:

• Attribution: Users must give appropriate credit to the original author(s) and the journal, provide a link to the license, and indicate if changes were made.

By submitting a manuscript to tjem, authors grant the journal the right of first publication, while retaining full ownership of their intellectual property.