A Gray Zone in Forensic Medical Practice: An Adult Case of SCIWORA

Traumatic myelopathic conditions without radiological findings are called spinal cord injury without radiographic abnormality (SCIWORA). Magnetic resonance imaging (MRI) is the standard diagnostic tool. Although first seen as a pediatric condition yet later began to be reported in adult populations too. In our case of a 27-year-old male who suffered a motor vehicle collision, there was a presentation of bilateral hyperesthesia in C4-C5 dermatomes. Patient's vitals, X-ray and computed tomography were normal. During the extended diagnostics, a bilateral, symmetrical signal intensity and a ''snake eyes'' sign were seen in MRI. Having a common injury mechanism, the diagnosis of SCIWORA continued to be overlooked, causing the forensic reporting to be erroneous, could lead to a loss of legal rights. In cases that have a relevant history and neurological signs that could be SCIWORA, using proper imaging and keeping forensic medical guides up to date remains a must.