ABSTRACT
History A 21-year-old woman is brought to the accident and emergency department with head and neck trauma after falling from a horse. She is immobilized on a board with a hard neck collar and complains of diffuse neck pain and mild intermittent tingling in the arms and legs. There is no history of loss of consciousness, no evidence of head injury (she had a riding helmet on) and no complaint of injury elsewhere. There is no significant past medical history although the patient has had intermittent neck pain in the past that has not been investigated.
