Complete cervical spinal cord injury from trauma

30-year-old patient in a motor vehicle collision presents with complete cord injury (ASIA grade A). Cervical spine MRI with sagittal T2 sequences (A) show hyperintense lesion consistent with contusion within the cervical spinal cord (bracket) from C4 to C6, prevertebral edema (arrow), and supra- and interspinous ligament tears (arrowheads). T2*-GRE MRI sequences in sagittal (B) and axial (C) planes show focal hematomyelia (dashed arrows) and fracture of left C5 lamina (arrowheads). Repeat cervical spine MRI with T2 sequences (D) performed after spinal fusion and decompression show the full extent of cord swelling and edema from contusion (bracket) and hematomyelia (thick arrow) at C5.