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Case Reports in Emergency Medicine
Volume 2014, Article ID 870580, 3 pages
Case Report

Expanding Prevertebral Soft Tissue Swelling Subsequent to a Motor Vehicle Collision

Department of Emergency Medicine, University of Florida, 1329 SW 16th Street, P.O. Box 1000186, Gainesville, FL 32610-0186, USA

Received 23 April 2014; Accepted 17 June 2014; Published 26 June 2014

Academic Editor: Kazuhito Imanaka

Copyright © 2014 Matthew F. Ryan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Cervical acceleration/deceleration or whiplash injuries are a common cause of cervical spine trauma. Cervical acceleration/deceleration can result in vertebral fractures, subluxations, and ligamentous and other soft tissue injuries. Severe injuries are often evidenced by increased prevertebral swelling on lateral X-ray. Assessment of the prevertebral space on lateral cervical spine films is an essential component for identifying potential traumatic neck injuries. We describe a case in which an 84-year-old man on coumadin presented to the emergency department after a low-impact motor vehicle crash. The patient initially complained of neck and shoulder pain which subsequently progressed to hoarseness, dysphagia, and dyspnea. Imaging studies revealed significant prevertebral tissue swelling with anterior compression of his airway that required airway stabilization via awake fiber-optic intubation and reversal of his anticoagulation therapy.