A suicide attempt with subtotal interruption of the high spinal cord without the involvement of any large vessels caused by a screwdriver in the neck: a case report

We report a case of a 40-year-old male who presented to the emergency department with a self-inflicted penetrating neck injury caused by a screwdriver, following a recent cancer diagnosis. This report outlines the urgent, radiological, and surgical management of the injury, emphasizing the challenges posed by cervical spinal trauma. Upon arrival, the patient was conscious and hemodynamically stable, despite the presence of a screwdriver lodged in the lateral cervical region. CT revealed a transfixing injury at the C2–C3 level with spinal cord disruption, without the involvement of major cervical vessels. Urgent surgical intervention, including foreign body extraction and stabilization procedures, was performed under general anesthesia. The screwdriver was removed without intraoperative complications. Despite initial stability, the patient’s condition progressively deteriorated because of respiratory failure associated with high cervical spinal cord damage. A few days later, the patient died from complications of spinal cord injury and loss of autonomous respiration. This case demonstrates the complexity of managing penetrating cervical spine trauma. Moreover, C2–C3 level injuries can rapidly lead to life-threatening neurological outcomes even in the absence of major vascular damage. Early imaging and a coordinated, multidisciplinary approach are critical for management; however, prognosis in cases of high spinal cord involvement remains poor.