How a broken vertebra can lead to a fatal hemorrhage: a case report
Dublin Core
Title
How a broken vertebra can lead to a fatal hemorrhage: a case report
Subject
Elderly, Spinal fracture, Hemorrhage, Diffuse idiopathic skeletal hyperostosis, Emergency medicine
Description
Background Unintentional falls are common among the elderly and given the expected increase of the aging popu-
lation, these falls contribute to a high number of admissions to the emergency department. Relatively low-energy
trauma mechanisms can lead to serious injuries in the elderly, with contributing factors being comorbidities, medica-
tion use and degenerative abnormalities.
Case presentation A 94-year-old female suffered an unintentional fall at home. Upon arrival of the ambulance
at her house she was hemodynamically stable and mobilized to the gurney with assistance. During primary survey
at the emergency department, her blood pressure and oxygen saturation decreased, she was not able to move her
legs anymore and lost consciousness. A full-body CTA was performed, which showed a fracture through the verte-
bral body of L2 with significant dislocation and a large active bleeding of the corpus, extending to the retroperito-
neum and the epidural space. Despite resuscitation, her vital signs deteriorated and given the severe abnormalities
on CTA, it was decided to discontinue further treatment, after which she deceased. The performed CTA and an x-ray
from 2016 suggested diffuse idiopathic skeletal hyperostosis, which might have contributed to the severity and insta-
bility of the vertebral fracture. Mobilization after the fall might have increased the dislocation of the fracture. The use
of oral anticoagulants worsened the subsequent bleeding and the extension to the epidural space caused the paraly-
sis of the legs.
Conclusions It is important to be aware of the possible serious consequences of unintentional falls in the elderly
population and to provide strict immobilization of the spinal column until proper imaging.
Keywords Elderly, Spinal fracture, Hemorrhage, Diffuse idiopathic skeletal hyperostosis, Emergency medicine
lation, these falls contribute to a high number of admissions to the emergency department. Relatively low-energy
trauma mechanisms can lead to serious injuries in the elderly, with contributing factors being comorbidities, medica-
tion use and degenerative abnormalities.
Case presentation A 94-year-old female suffered an unintentional fall at home. Upon arrival of the ambulance
at her house she was hemodynamically stable and mobilized to the gurney with assistance. During primary survey
at the emergency department, her blood pressure and oxygen saturation decreased, she was not able to move her
legs anymore and lost consciousness. A full-body CTA was performed, which showed a fracture through the verte-
bral body of L2 with significant dislocation and a large active bleeding of the corpus, extending to the retroperito-
neum and the epidural space. Despite resuscitation, her vital signs deteriorated and given the severe abnormalities
on CTA, it was decided to discontinue further treatment, after which she deceased. The performed CTA and an x-ray
from 2016 suggested diffuse idiopathic skeletal hyperostosis, which might have contributed to the severity and insta-
bility of the vertebral fracture. Mobilization after the fall might have increased the dislocation of the fracture. The use
of oral anticoagulants worsened the subsequent bleeding and the extension to the epidural space caused the paraly-
sis of the legs.
Conclusions It is important to be aware of the possible serious consequences of unintentional falls in the elderly
population and to provide strict immobilization of the spinal column until proper imaging.
Keywords Elderly, Spinal fracture, Hemorrhage, Diffuse idiopathic skeletal hyperostosis, Emergency medicine
Creator
Roxanne A. W. Ploumen1,2* , Martin R. van Wezenbeek1,3, Paul C. P. H. Willems4,5, Suzanne C. Gerretsen6 and
Jan A. Ten Bosch1,2
Jan A. Ten Bosch1,2
Source
https://doi.org/10.1186/s12245-024-00594-5
Date
2024
Contributor
Peri Irawan
Format
pdf
Language
english
Type
text
Files
Collection
Citation
Roxanne A. W. Ploumen1,2* , Martin R. van Wezenbeek1,3, Paul C. P. H. Willems4,5, Suzanne C. Gerretsen6 and
Jan A. Ten Bosch1,2, “How a broken vertebra can lead to a fatal hemorrhage: a case report,” Repository Horizon University Indonesia, accessed April 11, 2026, https://repository.horizon.ac.id/items/show/12275.