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In this report, we described the case of a 54-year-old female who suffered trauma from a falling large box (100 cm×30 cm×30 cm) that hit the vertex of her head while seated in a subway car. The patient experienced loss of consciousness for several minutes, and post-traumatic amnesia for several minutes, with a Glasgow Coma Scale score of 15. She experienced severe bursting pain in her head, neck and upper back immediately after the head trauma; and approximately 3 hours later, she began to feel pricking pain in her left arm and leg. Despite visits to several hospitals to determine the cause of pain, no specific diagnosis was confirmed. Ten months post-injury, she visited the Department of Rehabilitation of a Yeunnam University Hospital with the chief complaint of constant pain with hyperalgesia in her head, left arm, and leg. The characteristics and severity of pain were as follows: head, pricking sensation (visual analogue scale [VAS], 5–7]; left arm, pricking and squeezing (VAS, 3–7); and left leg, bursting sensation (VAS, 6–7). The subscales of Nottingham Sensory Assessment indicated normal kinesthetic sensation score of the left extremities (24 out of a possible 24 points), but impaired tactile sensation score (10 out of a possible 20 points). Brain and spine magnetic resonance imaging revealed no specific focal lesion; additionally, an electromyography study showed no evidence of peripheral neuropathy or radiculopathy.

Central Pain Due to Spinothalamic Tract Injury by Head Trauma Caused by Falling Object