Cervical spine injury leaves COPD patient with tough decision

A fall four months earlier has resulted in excruciating arm pain that hasn’t resolved in spite of physiotherapy

Rachel, is a 67-year-old pensioner who lives alone with her pup Toby. She has COPD and rheumatoid arthritis.

She presents with a four-month history of arm pain, following an incident on Christmas Day, when she reports that she went for a walk with Toby and had a fall, hitting her head.

She was take to emergency immediately after the fall, where a CT brain and cervical spine revealed a cavernous malformation causing proptosis.

Examination was reported as otherwise normal.