18 International Journal of Medical and Health Research ISSN: 2454-9142 www.medicalsciencejournal.com Volume 1; Issue 5; December 2015; Page No. 18-22 Knife blade penetrating as a non-missile injury to the cervical spine through the face: A case report 1 Joseph Musowoya, 2 Duncan D Mugala, 3 Alick Mwambungu, 4 Womba Kadochi, 5 Nathan Siulapwa 1 BSc, MB ChB, MMed (Surgery), FCS (ECSA). Consultant Surgeon: Ndola Central Hospital, Zambia. 2 BSc, MB ChB, MMed (Surgery), FCS (ECSA). Senior Lecturer: Copper Belt University-School of Medicine, Zambia. 3 BSc, MSc (Haem), Senior Lecturer: Ndola College of Biomedical Sciences, Zambia. 4 BSc, MB ChB, Registrar General Surgery Ndola Central Hospital, Zambia. 5 BSc, MSc, PhD, Head Basic Sciences- Copperbelt University- School of Medicine, Zambia. Abstract Spinal cord stab injuries (SCSI) are rare traumatic lesions when compared to injuries caused by road traffic accidents, sport activities and guns. We report a case of a 31-year-old male who was hospitalized because of being stabbed on the face and the blade penetrated the cervical spine. This was a serious physical violence between two men fighting over a woman. On admission, the patient had left hemiplegia with loss of reflexes and loss of sensation. All cranial nerves were intact, the heart sounds were normal though the patient was unable to shrug his left shoulder. The knife in our patient was very close to the vertebral arteries and the Circle of Willis. However, the long knife was gently removed and no significant bleeding or leakage of the cerebrospinal fluid occurred. The patient was put on antibiotics to avoid infections. The initial management of SCI is crucial for protecting undamaged spinal cord from secondary effects and Surgery should be considered as the first-line treatment in cases of incomplete injuries of the spinal cord with retained metallic object. In spite of scientific progresses, it is still not possible yet to repair a damaged spinal cord. Keywords: Knife, Stab, Face, Spine, Paralysis, Cervical Introduction Violence is a social disease that plagues all societies. Each society has its own form of violence. Chingola is a mining town in Zambia with a population of about 200,000 people. Chingola, like any other town has reports of violence and in the past, the pattern of physical violence in that town has been recorded [1] . The most frequently affected age group of violence in Chingola is in the range of 21 to 30 years. In this town victims of physical violence come from all the townships of Chingola. However the majority of the victims come from the medium and high density areas and very few victims come from low density areas [1] . It has been established that the most violent place is the home and this accounts for about 53.1% of all violent cases reported. Despite the fact that the most violent attackers are the thieves, the next most common attacker is the husband and the wife is the lowest attacker [1] . The most common cause of violence in a home is domestic confliction, where 85% of the women are the victims. The men (50%) are largely victims of thieves. It is known that the men are the most Knifed or stabbed (rarely by the wife) and commonly by the thieves. Violence involving use of stones are also widely seen in men and less so in women. The majority of the injuries in Chingola occur in the domestic situations. It is clear that victims are more likely to get a serious injury in a domestic conflict than in criminal violence or other conflicts. Authors are reporting on a case of a 31-year-old man who was stabbed on the face and the blade penetrated the cervical spine. This was a serious physical violence between two men fighting over a woman. Spinal cord stab injuries (SCSI) are rare traumatic lesions when compared to injuries caused by road traffic accidents, sport activities and guns [2] . The disability resulting from spinal cord injuries (SCI) puts a heavy burden on victims and the whole society concerning quality of life, working time loss and financial cost [3] . Stab injury of the spinal cord is a rare occurrence and its incidence varies according to the country. In the United States, only 1% of the spinal cord injuries result from stabbing [4] . In a large series from South Africa, 25% of spinal cord injuries were reported to result from sharp injuries and 84.2% of these sharp injuries resulted from stabbing [5] . Most of the injuries are caused by hemi-section of the spinal cord that results in incomplete neurological deficits [5] . The initial management of SCI is crucial for protecting undamaged spinal cord from secondary insults. In spite of scientific progresses, it is still not possible yet to repair a damaged spinal cord. Case details The victim was male, aged 31 years of age and lived in Mulando Township in Chingola, Zambia. He had separated from his wife with whom he had one male child who was 8 years old at the time of the incident. The victim was admitted to Ndola Central Hospital on 23 rd October 2015 and was complaining of pain in the neck. Circumstances surrounding his separation from his wife were that they had lived together for about 8 years prior to this incidence. He then left town and went to Lusaka to work for his uncle for about 6 months. When he came back, he found that his wife was living with another man with whom she was