CLOSED HEAD-INJURY IN SPINAL-CORD INJURED PATIENTS - RETROSPECTIVE STUDY OF LOSS OF CONSCIOUSNESS AND POST-TRAUMATIC AMNESIA

  • 1 January 1985
    • journal article
    • research article
    • Vol. 66  (1) , 41-43
Abstract
Previous studies of trauma-related spinal cord injured patients suggest that 25-50% of these patients sustain a concomitant cranio-cerebral trauma. A loss of consciousness (LOC) of 20 min duration or a post-traumatic amnesia (PTA) lasting 24 h is associated with deficits in concentration, attention, memory and higher-level cognitive functions. These may be significant factors influencing learning and adaptation during and after the formal rehabilitation process. A systematic review was performed on the medical records of 101 trauma-related spinal cord injured patients who were admitted to Northwestern Memorial Hospital and the Rehabilitation Institute of Chicago within 7 days of injury. The reported incidence of LOC and PTA in spinal cord injured patients was evaluated, and these data were compared with the level and etiology of injury, and with radiographic work-up, if any, for head injury. Eighty-seven percent of all emergency room [ER] admissions and 67% of all rehabilitation admissions were assessed for LOC. Fewer than 25% of all patients in both settings were assessed for PTA. Of all the patients 42% reported LOC, PTA, or both occurring simultaneously with the spinal cord injury. Assessment and incidence were unrelated to level of injury but were influenced by etiology. One-third of the patients who reported LOC, PTA, or both underwent further evaluation with computed tomographic (CT) scan or radiography of the skull. Assessment of LOC is conducted more consistently in the ER than in the rehabilitation setting. Assessment of PTA is performed infrequently despite its relevance to the rehabilitation process. Head injury may frequently be associated with traumatic spinal cord injury. Radiographic work-up of suspected head injury is not performed consistently in this population.

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