Abstract：
A 46-year-old man with neck pain and impaired physical mobility called for emergency medical services. The patient was able to communicate with the emergency medical team upon their arrival. However, he went into cardiopulmonary arrest 5 minutes later. Cardiopulmonary resuscitation was immediately performed, and the patient was admitted to our hospital with a Glasgow Coma Scale score of E1V1M1. His respiratory rate was 5 breaths/minute and his partial pressure of carbon dioxide in arterial blood (PaCO2) was 127 mmHg, necessitating intubation and ventilation. His consciousness improved as the PaCO2 level decreased. However, he was unable to be weaned off the ventilator and breathe independently. Neurological examination revealed flaccid quadriplegia, pain sensation up to the C5 level, absence of deep tendon reflexes, indifferent plantar responses, and absence of the rectoanal inhibitory reflex. Magnetic resonance imaging showed a hyperintense lesion with slight enlargement of the anterior two-thirds of the spinal cord at the C2-C4 level on both T2-weighted and diffusion-weighted images, consistent with a diagnosis of spinal cord infarction. Although the quadriplegia and sensory loss partially improved, the patient was unable to be weaned from the ventilator. Cervical cord infarction of the anterior spinal artery can cause rapid respiratory failure leading to cardiopulmonary arrest. Therefore, cervical cord infarction should be included as a differential diagnosis when examining patients after cardiopulmonary resuscitation.
摘要：
一名患有颈部疼痛和身体活动障碍的46岁男子呼吁紧急医疗服务。患者能够在到达时与紧急医疗小组进行沟通。然而,5分钟后，他进入心肺骤停。立即进行心肺复苏,患者入院，格拉斯哥昏迷评分为E1V1M1。他的呼吸频率为5次呼吸/分钟，动脉血中的二氧化碳分压（PaCO2）为127mmHg，需要插管和通气。随着PaCO2水平的降低，他的意识得到了改善。然而,他无法脱离呼吸机和独立呼吸。神经系统检查显示弛缓性四肢瘫痪,疼痛感觉达到C5水平，没有深肌腱反射，冷漠的足底反应，并且没有直肠肛门抑制性反射.磁共振成像在T2加权和弥散加权图像上都显示出高强度病变，在C2-C4水平上脊髓前三分之二略有扩大，符合脊髓梗塞的诊断.虽然四肢瘫痪和感觉丧失部分改善，病人无法从呼吸机上断奶。脊髓前动脉的颈索梗塞可引起快速呼吸衰竭，导致心肺骤停。因此,在心肺复苏后检查患者时，应将颈髓梗死作为鉴别诊断。
