Pentaplegia is a spinal cord injury at or above C4 level, resulting in complete loss of motor functions below the injury level and paralysis of respiratory muscles. Facial injuries might be a factor for early identification of these patients and in implying prompt management. Here, we report a patient who was injured in a motor vehicle accident and sustained facial injury and cardiopulmonary symptoms. His imaging studies showed atlanto-axial dissociation and maxillary fracture. He survived the accident but continued to have pentaplegia. Presence of facial fractures might help in suspicion and early identification of such injuries, where prompt management remains essential for survival in complete pentaplegia and for avoiding deterioration in incomplete injuries.
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