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Acute cervical spinal cord injury

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https://www.readbyqxmd.com/read/29160143/some-autonomic-deficits-of-acute-or-chronic-cervical-spinal-contusion-reversed-by-interim-brainstem-stimulation
#1
Alberto A Vitores, Stephanie S Sloley, Catalina Martinez, Melissa M Carballosa-Gautam, Ian D Hentall
Prolonged electrical stimulation of the hindbrain's nucleus raphe magnus (NRM) or its major midbrain input region, the periaqueductal gray (PAG), was previously found in rats to promote recovery from sensory-motor and histological deficits of acute thoracic spinal cord injury (SCI). Here, some visceral deficits of acute and chronic midline cervical (C5) contusion are similarly examined. Cranially implanted wireless stimulators delivered intermittent 8 Hz, 30-70 µA cathodal pulse trains to a brainstem microelectrode...
November 21, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29141498/incidence-and-natural-progression-of-neurogenic-shock-following-traumatic-spinal-cord-injury
#2
Ian A Ruiz, Jordan W Squair, Aaron A Phillips, Christine D Lukac, Dayan Huang, Patrick Oxciano, Dong Yan, Andrei V Krassioukov
Neurogenic shock, a distributive type of circulatory shock following spinal cord injury (SCI), results in profound hypotension. The consequent hemodynamic instability complicates clinical management, delays surgical intervention, and impacts neurological outcome. Moreover, the reported incidence of this condition varies significantly. Here, we establish the true incidence of neurogenic shock by comparing the most common clinical definitions used to diagnose the condition. Further, we characterize the acute progression and recovery of neurogenic shock...
November 15, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29138486/the-impact-of-a-specialized-spinal-cord-injury-center-as-compared-with-non-specialized-centers-on-the-acute-respiratory-management-of-patients-with-complete-tetraplegia-an-observational-study
#3
Andréane Richard-Denis, Debbie Feldman, Cynthia Thompson, Martin Albert, Jean-Marc Mac-Thiong
STUDY DESIGN: Retrospective cohort study. OBJECTIVES: To compare the proportion of tracheostomy placement and duration of mechanical ventilation (MV) in patients with a complete cervical spinal cord injury (SCI) that were managed early or lately in a specialized acute SCI-center. The second objective was to determine the impact of the timing of admission to the SCI-center on the MV support duration. SETTING: A single Level-1 trauma center specialized in SCI care in Quebec (Canada)...
November 15, 2017: Spinal Cord
https://www.readbyqxmd.com/read/29138091/longitudinal-electrophysiological-changes-after-cervical-hemi-contusion-spinal-cord-injury-in-rats
#4
Zucheng Huang, Rong Li, Junhao Liu, Zhiping Huang, Yong Hu, Xiaoliang Wu, Qingan Zhu
OBJECTIVE: To evaluate the longitudinal somatosensory evoked potentials (SEPs) and motor evoked potentials (MEPs) characterization from acute to chronic injury following cervical hemi-contusion spinal cord injury (SCI) in rats, and correlate the MEPs & SEPs to the behavioral outcomes. METHODS: Fifteen adult male Sprague-Dawley rats were subjected to the hemi-contusion spinal cord injury at C5. Forelimb MEPs & SEPs were applied to 5 animals before injury and 3h, 1d, 3d, 1w, 2w, 4w and 8w after injury respectively...
November 11, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/29088944/the-impact-of-blood-pressure-management-after-spinal-cord-injury-a-systematic-review-of-the-literature
#5
Yamaan S Saadeh, Brandon W Smith, Jacob R Joseph, Sohaib Y Jaffer, Martin J Buckingham, Mark E Oppenlander, Nicholas J Szerlip, Paul Park
OBJECTIVE Spinal cord injury (SCI) results in significant morbidity and mortality. Improving neurological recovery by reducing secondary injury is a major principle in the management of SCI. To minimize secondary injury, blood pressure (BP) augmentation has been advocated. The objective of this study was to review the evidence behind BP management after SCI. METHODS This systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Using the PubMed database, the authors identified studies that investigated BP management after acute SCI...
November 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/29066098/brown-s%C3%A3-quard-syndrome-and-cervical-post-traumatic-subarachnoid-hematoma
#6
Fernando Rascón-Ramírez, Josué M Avecillas-Chasín, Albert Trondin, M Javier Arredondo
Cervical Traumatic SSH are very rare in literature. They are usually caused by cardiopulmonary diseases that increase vascular pressure causing spinal vessels rupture. In thoracolumbar spine, the spinal puncture is the most common cause. The ventrolateral position is even more unusual. In traumatic brain injury (TBI), an abrupt extension-flexion movement could have caused the rupture of subarachnoid vessels. This, accompanied by the slowed blood "wash out" (probably due to the previous osteoarthrosis and spinal canal stenosis), led to the formation of an organized clot, which caused an acute spinal cord compression syndrome...
October 20, 2017: Neurocirugía
https://www.readbyqxmd.com/read/29057991/risks-factors-of-mechanical-ventilation-in-acute-traumatic-cervical-spinal-cord-injured-patients
#7
Antonio Montoto-Marqués, Natalia Trillo-Dono, María Elena Ferreiro-Velasco, Sebastián Salvador-de la Barrera, Antonio Rodriguez-Sotillo, Mónica Mourelo-Fariña, Rita Galeiras-Vázquez, Rosa Meijide-Failde
STUDY DESIGN: Descriptive retrospective study. OBJECTIVES: To analyze risk factors associated with mechanical ventilation (MV) in cases of acute traumatic Cervical Spinal Cord Injury (tCSCI). SETTING: Unidad de Lesionados Medulares, Complejo Hospitalario Universitario A Coruña, in Galicia (Spain). METHODS: The study included patients with tCSCI who were hospitalized between January 2010 and December 2014. The following variables were analyzed: age, gender, etiology, neurological level, ASIA (American Spinal Injury Association) grade, associated injuries, injury severity score (ISS), ASIA motor score (AMS) at admission and mortality...
October 23, 2017: Spinal Cord
https://www.readbyqxmd.com/read/29037121/predicting-injury-severity-and-neurologic-recovery-after-acute-cervical-spinal-cord-injury-a-comparison-of-cerebrospinal-fluid-and-magnetic-resonance-imaging-biomarkers
#8
Turker Dalkilic, Nader Fallah, Vanessa K Noonan, Sanam Salimi Elizei, Kevin Dong, Lise M Belanger, Leanna Ritchie, Angela Tsang, Etienne Bourassa-Moreau, Manraj K S Heran, Scott J Paquette, Tamir Ailon, Nicolas Dea, John Street, Charles G Fisher, Marcel F Dvorak, Brian K Kwon
Biomarkers of acute human spinal cord injury (SCI) could provide a more objective measure of spinal cord damage and a better predictor of neurologic outcome than the current functional neurologic assessments. There has been growing interest in establishing neurochemical biomarkers using cerebrospinal fluid (CSF) and also imaging biomarkers using measurable features on MRI. In this study, we took the opportunity to compare CSF biomarkers and MRI biomarkers in a cohort of acute cervical SCI patients who had undergone both CSF sampling and pre-operative MRI scanning...
October 17, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29019639/spine-conditions-cervical-spine-conditions
#9
Marc A Childress
There are a variety of causes of neck pain, including trauma and degenerative changes. The history of onset helps to direct evaluation, including the need for imaging or ancillary testing. Patterns of pain, weakness, and other specific physical examination findings also aid in diagnosis. Management of most soft tissue injuries involves early mobilization, whereas fractures are managed based on patterns of instability. Acute spinal cord injury requires emergent care, to include possible decompressive surgery...
October 2017: FP Essentials
https://www.readbyqxmd.com/read/28993348/delayed-spinal-cord-infarction-following-anterior-cervical-surgical-decompression
#10
Muhammad Faheem Khan, Rashid Jooma, Fauzan Alam Hashmi, Muhammad Faraz Raghib
Anterior cervical discectomy and fusion (ACDF) for cord compression is a safe and effective procedure with good outcomes. However, worsening of myelopathy is the most feared adverse event of the surgery. We report the case of a 36-year-old male patient who presented with an acute non-traumatic C5-6 cervical disc herniation causing incomplete quadriparesis. He underwent an uncomplicated ACDF at C5-6, and after an initial period of improvement, he developed a delayed onset of an anterior cord syndrome on day 3, without any discerning cause...
October 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28993290/spinal-cord-injury-associated-with-cervical-spinal-canal-stenosis-outcomes-and-prognostic-factors
#11
Y Ronzi, B Perrouin-Verbe, O Hamel, R Gross
OBJECTIVES: To specify outcomes and identify prognostic factors of neurologic and functional recovery in patients with an acute traumatic spinal cord injury (SCI) associated with cervical spinal canal stenosis (SCS), without spinal instability. METHODS: A retrospective study was conducted using data from a Regional Department for SCI rehabilitation in France. A description of the population characteristics, clinical data and neurological and functional outcomes of all patients treated for acute SCI due to cervical trauma associated with SCS was performed...
October 6, 2017: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/28973360/motor-evoked-potentials-correlate-with-magnetic-resonance-imaging-and-early-recovery-after-acute-spinal-cord-injury
#12
Sanjay S Dhall, Jenny Haefeli, Jason F Talbott, Adam R Ferguson, William J Readdy, Jacqueline C Bresnahan, Michael S Beattie, Jonathan Z Pan, Geoffrey T Manley, William D Whetstone
BACKGROUND: While the utilization of neurophysiologic intraoperative monitoring with motor evoked potentials (MEPs) has become widespread in surgery for traumatic spine fractures and spinal cord injury (SCI), clinical validation of its diagnostic and therapeutic benefit has been limited. OBJECTIVE: To describe the use of intraoperative MEP at a large level I trauma center and assess the prognostic capability of this technology. METHODS: The SCI REDCap database at our institution, a level I trauma center, was queried for acute cervical SCI patients who underwent surgery with intraoperative monitoring between 2005 and 2011, yielding 32 patients...
July 7, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28972191/effects-of-acute-intermittent-hypoxia-on-hand-use-after-spinal-cord-trauma-a-preliminary-study
#13
RANDOMIZED CONTROLLED TRIAL
Randy D Trumbower, Heather B Hayes, Gordon S Mitchell, Steven L Wolf, Victoria A Stahl
OBJECTIVE: To test the hypothesis that daily acute intermittent hypoxia (AIH) combined with hand opening practice improves hand dexterity, function, and maximum hand opening in persons with chronic, motor-incomplete, cervical spinal cord injury. METHODS: Six participants completed the double-blind, crossover study. Participants received daily (5 consecutive days) AIH (15 episodes per day: 1.5 minutes of fraction of inspired oxygen [FIo2] = 0.09, 1-minute normoxic intervals) followed by 20 repetitions of hand opening practice and normoxia (sham, FIo2 = 0...
October 31, 2017: Neurology
https://www.readbyqxmd.com/read/28960655/urgent-closed-reduction-of-the-dislocated-cervical-spine-in-new-zealand
#14
Richard N Storey, Raj Singhal, Tom Inglis, David Kieser, Rowan Schouten
BACKGROUND: Emergent decompression, either by closed reduction or surgical decompression, of the acutely compressed cervical spinal cord is recognized as important in minimizing the neurological outcomes of these injuries. The aim of this study is to optimize New Zealand's capability to perform closed reductions. METHODS: Regional hospitals throughout New Zealand were surveyed on their capability to reduce acute cervical spine dislocations using traction. A systematic literature review was performed to investigate aspects of patient selection, reduction technique and the outcomes achieved with closed reduction of such injuries...
September 28, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28904564/the-role-of-pre-reduction-mri-in-the-management-of-complex-cervical-spine-fracture-dislocations-an-ongoing-controversy
#15
Sergiu Botolin, Todd F VanderHeiden, Ernest E Moore, Herbert Fried, Philip F Stahel
BACKGROUND: Cervical spine fracture-dislocations in neurologically intact patients represent a surgical challenge due to the risk of inflicting iatrogenic spinal cord compression by closed reduction maneuvers. The use of MRI for early advanced imaging in these injuries remains controversially debated. CASE PRESENTATION: A 54-year old man sustained a fall over the handlebars of his racing bicycle. The helmeted patient sustained a fall on his head which resulted in a hyperflexion injury of the neck...
2017: Patient Safety in Surgery
https://www.readbyqxmd.com/read/28890805/outcome-after-post-acute-spinal-cord-specific-rehabilitation-a-german-single-center-study
#16
Matthias Ponfick
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: The objective of this study was to analyze single center outcome measures of spinal cord injury (SCI)-specific rehabilitation (SCISR) in Germany. SETTING: The study was conducted at an SCI specialized rehabilitation center. METHODS: Nonparametric tests for outcome description such as SCIM and length of stay. Logistic regression for outcome prediction was used. RESULTS: One hundred and sixty patients (113 men, 47 women) with a mean age of 64...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28885343/risk-factors-and-the-surgery-affection-of-respiratory-complication-and-its-mortality-after-acute-traumatic-cervical-spinal-cord-injury
#17
Xiao-Xiong Yang, Zong-Qiang Huang, Zhong-Hai Li, Dong-Feng Ren, Jia-Guang Tang
The aim of this study is to estimate the risk factors of both respiratory complication (RC) and mortality after acute traumatic cervical spinal cord injury (TCSCI). Between July 2005 and July 2015, in 181 patients (142 males and 39 females; mean age 41.0 years) with acute TCSCI, we compared the difference and odds ratio in RC group (n = 73) with that of non-RC group (n = 108), and also death group (n = 15) and survival group (n = 166). We collected injury-related information after half a year of injury, which is as follows: the causes of injury, time of surgery, ICU (intensive care unit) days, ventilator days, ASIA (American Spinal Injury Association) classification, neurological injury, CIPS (Clinical Pulmonary Infection Score), and BMI (body mass index)...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28872148/incidence-of-traumatic-spinal-cord-injury-in-italy-during-2013-2014-a-population-based-study
#18
S Ferro, L Cecconi, J Bonavita, M C Pagliacci, A Biggeri, M Franceschini
STUDY DESIGN: Observational prospective population-based incidence study. OBJECTIVES: The main objective of this study was to assess the incidence of traumatic spinal cord injuries (TSCIs) and incidence rates, in order to provide estimates by age, gender, characteristics and cause. SETTING: This study was conducted at acute-care spinal cord injury (SCI) hospitals and SCI centers from 11 Italian regions, between 1 October 2013 and 30 September 2014...
September 5, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28818826/test-retest-and-interreader-reproducibility-of-semiautomated-atlas-based-analysis-of-diffusion-tensor-imaging-data-in-acute-cervical-spine-trauma-in-adult-patients
#19
D J Peterson, A M Rutman, D S Hippe, J G Jarvik, F H Chokshi, M R Reyes, C H Bombardier, M Mossa-Basha
BACKGROUND AND PURPOSE: DTI is a tool for microstructural spinal cord injury evaluation. This study evaluated the reproducibility of a semiautomated segmentation algorithm of spinal cord DTI. MATERIALS AND METHODS: Forty-two consecutive patients undergoing acute trauma cervical spine MR imaging underwent 2 axial DTI scans in addition to their clinical scan. The datasets were put through a semiautomated probabilistic segmentation algorithm that selected white matter, gray matter, and 24 individual white matter tracts...
August 17, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28798719/fulminant-acute-ascending-hemorrhagic-myelitis-treated-with-eculizumab
#20
Nang Boe Ohnmar Hsam, Klemens Angstwurm, Sebastian Peters, Kornelius Fuchs, Gerhard Schuierer, Ulrich Bogdahn, Robert Weissert
We describe an 18-year-old patient who developed back pain, rapidly ascending sensomotory deficits, bladder dysfunction, Lhermitte's sign, absent abdominal reflexes of all three levels, brisk tendon reflexes, and positive Babinski's sign. Magnetic resonance imaging of the spinal cord showed a long segment of cervical and thoracic intramedullary signal hyperintensity suggesting a longitudinally extensive transverse myelitis possibly within the course of a fast progressing ascending immune-mediated hemorrhagic myelopathy...
2017: Frontiers in Neurology
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