A patient who fell from height and has leg paralysis should be evaluated for what condition?

• A. Spinal injury
• B. Brain injury
• C. Pulmonary edema
• D. Myocardial infarction

Answer: (A)

High-energy trauma with leg paralysis points to possible spinal injury, since paralysis indicates disruption of the spinal cord or its nerve pathways. In trauma care, the priority is to protect the spine and assess for spinal cord damage, because missing a spinal injury can lead to permanent disability. Immediate steps include immobilizing the spine, maintaining airway and circulation, and performing a careful neurological exam (checking motor and sensory function). Imaging is essential: a CT scan of the spine is typically done first to look for fractures or dislocations, with MRI used if there’s concern for spinal cord compression or to evaluate soft tissue structures.

Brain injury could cause changes in consciousness or cognitive signs, but leg paralysis specifically raises concern for spinal injury rather than a brain problem. Pulmonary edema and myocardial infarction are less likely explanations for isolated leg paralysis in a fall and would present with respiratory symptoms or chest/ECG findings, not a primary neurological deficit.