Woman Survives 'Internal Decapitation'

[Amelia]

Woman Survives 'Internal Decapitation'

By The Associated Press

17 May 2007

DENVER - Even her surgeon calls her a miracle. Shannon Malloy was critically injured Jan. 25 when a car crash slammed her into the dashboard. Her skull separated from her spine, although her skin, spinal cord and other internal organs remained intact.

The rare condition is known as clinically as internal decapitation, and it left her with no control over her head.

Her injuries left Malloy with nerve damage that made her eyes cross, and she has difficulty swallowing. She was not paralyzed. She told her story to Denver station KMGH-TV.

Dr. Gary Ghiselli, an orthopedic spine surgeon at the Denver Spine Center, said he and his colleagues had never seen such an injury in someone still living.

"I've seen it once before," Ghiselli said, "and, unfortunately, the patient didn't make it."

Even after the crash, physicians in Nebraska, where Malloy lives, told relatives they should prepare to say their goodbyes.

Ghiselli said a will to survive kept Malloy, 30, alive long enough for surgeons to insert screws in her head and neck and attach a halo to minimize movement - no easy task.

"My skull slipped off my neck about five times," Malloy said. "Every time they tried to screw this to my head, I would slip."

Doctors eventually stabilized her head and strengthened her neck. The halo has since been removed.

"It's a miracle that she was able to survive from the actual accident," Ghiselli said. "It's a miracle that she's made the progress that she's made."

[rudywoofs (Pam)]

This reminds me very much of an incident in the ER where I worked about 10 years ago. An 80-something yr old lady had chronic weakness and her elderly husband took care of her. In the late evening the husband called 911 to report that his wife was not breathing, and the paramedics arrived pronto, and began CPR. She was still not breathing on her own when she got to the ER. So....based on the information the husband had given to the paramedics, the ER doc put in a breathing tube and Respiratory Therapy hooked her up to a respirator. But they could not figure out why she was unable to breathe on her own.

Someone finally thought of doing a neck xray to see if there was a foreign object in her throat. There was none. But it DID show that this patient's skull was entirely disconnected from her spine....she had fractures of C1 and C2 (the first 2 vertebrae of the neck), and it appeared that most of her spinal cord at that level had been severed or severely compressed.

What happened is that the husband had been trying to help his wife into a chair from her walker. Their legs got tangled up and they both fell....it was believed she fractured the vertebrae at that time. But since the paramedics had not been told of the fall, they did not aggressively protect the neck as they normally would. And the ER physician would have never tilted the patient's head backwards to insert the breathing tube.

It was so sad. We had to tell the husband that his wife would not recover. And then we had to try and explain the reasons why....without making him feel responsible. And then the husband made the decision to have his wife disconnected from the life support system. It didn't take more than 30 minutes before she was gone.

I've seen a lot a deaths in the ER, but that was one of the saddest.