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case_images: (a) Sagittal STIR MR shows a hyperintense signal along the dorsal mid-thoracic soft tissue wound tract, extending into the spinal canal with T5 level cord disruption and T5 vertebral body marrow oedema. (b) Sagittal T2WI MR demonstrates cord oedema as a hyperintense signal of the central cord (T3 to T6 level).
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case_images: T5 (Fig. 1a). There was an associated right spinal epidural hematoma with resultant compression of the cord and cord oedema (Figs 1b and 2a). The Neurosurgery team elected to manage the injury conservatively.
case_images: (a) Axial T2WI MR at the midthoracic level demonstrates an epidural hematoma in the right lateral spinal canal with compression of the cord (arrow) and bilateral hydrothoraces (*). (b) Axial T2WI MR shows a round lesion (arrow) inseparable from the medial aspect of the mid-thoracic aorta (A), with an isointense signal to the thoracic aorta.
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case_images: There was an associated right spinal epidural hematoma with resultant compression of the cord and cord oedema (Figs 1b and 2a). The Neurosurgery team elected to manage the injury conservatively. T4-5 level, inseparable from the medial aspect of the mid-thoracic aorta, at the level of the penetrating wound (Fig. 2b).
case_images: CT angiogram of the chest confirms a pseudoaneurysm (arrow) of the thoracic aorta (A), with surrounding mediastinal haematoma and bilateral haemothoraces.
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case_images: These findings were concerning for a traumatic aortic injury, and the patient was therefore referred for an urgent computed tomography (CT) angiogram of the chest. The CT angiogram confirmed a pseudoaneurysm of the descending aorta, 3 mm in diameter, associated with a mediastinal hematoma and bilateral haemothoraces (Fig. 3).