High-voltage electrical injury associated with long-segment cervical myelopathy and odontoid process fracture: A rare case report

High-voltage electrical injuries are life-threatening emergencies associated with extensive cutaneous damage and multisystem involvement. Neurological complications, particularly spinal cord injury, are rare and incompletely understood [1] , [2] , [3] . A 24-year-old male sustained a high-voltage electrical injury following accidental contact with a live railway overhead wire. He developed superficial to deep dermal electrical burns involving approximately 45% of the total body surface area, predominantly affecting the anterior chest wall, right upper limb, and left lower limb. Neurological examination revealed quadriparesis. Magnetic resonance imaging of the cervical spine demonstrated long-segment intramedullary signal changes extending from the cervicomedullary junction to the C4 vertebral level, consistent with electrical myelopathy. Computed tomography revealed an undisplaced fracture at the base of the odontoid process. The patient was managed conservatively with cervical immobilization, intensive care monitoring, systemic corticosteroids, and targeted burn wound care. The coexistence of long-segment cervical myelopathy and odontoid fracture following high-voltage electrical injury is exceptionally rare. Early spinal imaging, accurate burn assessment, and coordinated multidisciplinary management are essential to optimize neurological and functional outcomes.