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Acute cervical spinal cord injury

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https://www.readbyqxmd.com/read/28798719/fulminant-acute-ascending-hemorrhagic-myelitis-treated-with-eculizumab
#1
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
https://www.readbyqxmd.com/read/28771534/neural-stem-cell-mediated-recovery-is-enhanced-by-chondroitinase-abc-pretreatment-in-chronic-cervical-spinal-cord-injury
#2
Hidenori Suzuki, Christopher S Ahuja, Ryan P Salewski, Lijun Li, Kajana Satkunendrarajah, Narihito Nagoshi, Shinsuke Shibata, Michael G Fehlings
Traumatic spinal cord injuries (SCIs) affect millions of people worldwide; the majority of whom are in the chronic phase of their injury. Unfortunately, most current treatments target the acute/subacute injury phase as the microenvironment of chronically injured cord consists of a well-established glial scar with inhibitory chondroitin sulfate proteoglycans (CSPGs) which acts as a potent barrier to regeneration. It has been shown that CSPGs can be degraded in vivo by intrathecal Chondroitinase ABC (ChABC) to produce a more permissive environment for regeneration by endogenous cells or transplanted neural stem cells (NSCs) in the subacute phase of injury...
2017: PloS One
https://www.readbyqxmd.com/read/28761518/factors-affecting-outcome-of-acute-cervical-spine-injury-a-prospective-study
#3
Bhavanam Hanuma Srinivas, Alugolu Rajesh, A K Purohit
BACKGROUND: Injury to the spine and spinal cord is one of the common cause of disability and death. Several factors affect the outcome; but which are these factors (alone and in combination), are determining the outcomes are still unknown. The aim of the study was to evaluate the factors influencing the outcome following acute cervical spine injury. MATERIALS AND METHODS: A prospective observational study at single-center with all patients with cervical spinal cord injury (SCI), attending our hospital within a week of injury during a period of October 2011 to July 2013 was included for analysis...
July 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28732686/health-conditions-impact-on-function-health-related-quality-of-life-and-life-satisfaction-following-traumatic-spinal-cord-injury-a-prospective-observational-registry-cohort-study
#4
Carly S Rivers, Nader Fallah, Vanessa K Noonan, David Gt Whitehurst, Carolyn Schwartz, Joel Finkelstein, B Catharine Craven, Karen Ethans, Colleen O'Connell, Catherine Truchon, Chester Ho, A Gary Linassi, Christine Short, Eve Tsai, Brian Drew, Henry Ahn, Marcel F Dvorak, Jérôme Paquet, Michael G Fehlings, Luc Noreau
OBJECTIVE: To analyze relationships among injury, demographic and environmental factors on function, HRQoL and life satisfaction in individuals with traumatic SCI. DESIGN: prospective observational registry cohort study SETTING: 31 acute and rehabilitation SCI centres PARTICIPANTS: Participants (N=340) from the Rick Hansen Spinal Cord Injury Registry (RHSCIR) who were prospectively recruited from 2004-2014 were included. The model cohort included 340 participants: 79...
July 18, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28724333/the-impact-of-acute-management-on-the-occurrence-of-medical-complications-during-the-specialized-spinal-cord-injury-acute-hospitalization-following-motor-complete-cervical-spinal-cord-injury
#5
Andréane Richard-Denis, Debbie Erhmann Feldman, Cynthia Thompson, Jean-Marc Mac-Thiong
CONTEXT/OBJECTIVE: Determine the impact of early admission and complete perioperative management in a specialized spinal cord injury (SCI) trauma center (SCI-center) on the occurrence of medical complications following tetraplegia. DESIGN: A retrospective comparative cohort study of prospectively collected data involving 116 individuals was conducted. Group 1 (N=87) was early managed in a SCI-center promptly after the trauma, whereas Group 2 (N=29) was surgically and preoperatively managed in a non-specialized (NS) center before being transferred to the SCI-center...
July 19, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28683592/functional-outcomes-in-individuals-undergoing-very-early-5%C3%A2-h-and-early-5-24%C3%A2-h-surgical-decompression-in-traumatic-cervical-spinal-cord-injury-analysis-of-neurological-improvement-from-the-austrian-spinal-cord-injury-study
#6
Georg Mattiassich, Maria Gollwitzer, Franz Gaderer, Martina Blocher, Michael Osti, Markkus Lill, Reinhold Ortmaier, Thomas Haider, Wolfgang Hitzl, Herbert Resch, Stephanie Aschauer-Wallner
Our study aim was to assess the neurological outcomes of surgical decompression and stabilization within 5 and 24 h after injury. We performed a multi-center, retrospective cohort study in adolescents and adults 15-85 years of age presenting cervical spinal cord injury (CSCI) at one of 6 Austrian trauma centers participating in the Austrian Spinal Cord Injury Study (ASCIS). Neurological outcomes were measured using the American Spinal Injury Association Impairment Scale (AIS) grade according to the International Standards For Neurological Classification Of Spinal Cord Injury (ISNCSCI) form after at least 6 months of follow-up (FU)...
August 10, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28673831/risk-factors-for-laryngeal-penetration-aspiration-in-patients-with-acute-traumatic-cervical-spinal-cord-injury
#7
Tiina Ihalainen, Irina Rinta-Kiikka, Teemu M Luoto, Tuomo Thesleff, Mika Helminen, Anna-Maija Korpijaakko-Huuhka, Antti Ronkainen
BACKGROUND CONTEXT: Laryngeal penetration-aspiration, the entry of material into the airways, is considered the most severe subtype of dysphagia and is common among patients with acute cervical spinal cord injury (SCI). PURPOSE: The aim of this study was to investigate risk factors for penetration-aspiration in patients with acute traumatic cervical spinal cord injury (TCSCI). STUDY DESIGN: This is a prospective cohort study. PATIENT SAMPLE: Thirty-seven patients with TCSCI were included in the study...
June 30, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28673827/the-impact-of-spine-stability-on-cervical-spinal-cord-injury-with-respect-to-demographics-management-and-outcome-a-prospective-cohort-from-a-national-spinal-cord-injury-registry
#8
Jérôme Paquet, Carly S Rivers, Dilnur Kurban, Joel Finkelstein, Jin W Tee, Vanessa K Noonan, Brian K Kwon, R John Hurlbert, Sean Christie, Eve C Tsai, Henry Ahn, Brian Drew, Christopher S Bailey, Daryl R Fourney, Najmedden Attabib, Michael G Johnson, Michael G Fehlings, Stefan Parent, Marcel F Dvorak
BACKGROUND CONTEXT: Emergent surgery for patients with a traumatic spinal cord injury (SCI) is seen as the gold standard in acute management. However, optimal treatment for those with the clinical diagnosis of central cord syndrome (CCS) is less clear, and classic definitions of CCS do not identify a unique population of patients. PURPOSE: The study aimed to test the authors' hypothesis that spine stability can identify a unique group of patients with regard to demographics, management, and outcomes, which classic CCS definitions do not...
July 1, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28669296/a-neurophysiological-approach-to-nerve-transfer-to-restore-upper-limb-function-in-cervical-spinal-cord-injury
#9
Ross M Mandeville, Justin M Brown, Geoffrey L Sheean
A successful nerve transfer surgery can provide a wealth of benefits to a patient with cervical spinal cord injury. The process of surgical decision making ideally uses all pertinent information to produce the best functional outcome. Reliance on clinical examination and imaging studies alone can miss valuable information on the state of spinal cord health. In this regard, neurophysiological evaluation has the potential to effectively gauge the neurological status of even select pools of anterior horn cells and their axons to small nerve branches in question to determine the potential efficacy of their use in a transfer...
July 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28653674/effects-of-orthotic-therapeutic-electrical-stimulation-in-the-treatment-of-patients-with-paresis-associated-with-acute-cervical-spinal-cord-injury-a-randomized-control-trial
#10
K Iwahashi, T Hayashi, R Watanabe, A Nishimura, T Ueta, T Maeda, K Shiba
STUDY DESIGN: A randomized controlled trial. OBJECTIVES: To determine the effects of orthotic therapeutic electrical stimulation (TES) on the hand in patients with paresis associated with acute cervical spinal cord injury. SETTING: Spinal Injuries Center, Fukuoka, Japan. METHODS: The study included patients treated for spinal cord injuries (Frankel classification, grades B and C) at our institution within 1 week post injury between May 2011 and December 2014...
June 27, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28631744/traumatic-cervical-spinal-cord-injury-a-prospective-clinical-study-of-laryngeal-penetration-and-aspiration
#11
T Ihalainen, I Rinta-Kiikka, T M Luoto, E A Koskinen, A-M Korpijaakko-Huuhka, A Ronkainen
STUDY DESIGN: Prospective cohort study. OBJECTIVES: Dysphagia is a relatively common secondary complication in patients with traumatic cervical spinal cord injuries (TCSCI). The purpose of this study was to determine the incidence of aspiration and penetration in patients with acute TCSCI. SETTING: Tampere University Hospital, Tampere, Finland. METHODS: A total of 46 patients with TCSCI were evaluated with a videofluoroscopic swallowing study (VFSS)...
June 20, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28628531/costs-and-length-of-stay-for-the-acute-care-of-patients-with-motor-complete-spinal-cord-injury-following-cervical-trauma-the-impact-of-early-transfer-to-specialized-acute-sci-center
#12
Andréane Richard-Denis, Debbie Ehrmann Feldman, Cynthia Thompson, Étienne Bourassa-Moreau, Jean-Marc Mac-Thiong
OBJECTIVE: Acute spinal cord injury (SCI) centers aim to optimize outcome following SCI. However, there is no timeframe to transfer patients from regional to SCI centers in order to promote cost-efficiency of acute care. Our objective was to compare costs and length of stay (LOS) following early and late transfer to the SCI center. DESIGN: A retrospective cohort study involving 116 individuals was conducted. Group 1 (n = 87) was managed in an SCI center promptly after the trauma, whereas group 2 (n = 29) was transferred to the SCI center only after surgery...
July 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28592693/nongenomic-actions-of-17-%C3%AE-estradiol-restore-respiratory-neuroplasticity-in-young-ovariectomized-female-rats
#13
Brendan J Dougherty, Elizabeth S Kopp, Jyoti J Watters
Gonadal steroids modulate CNS plasticity, including phrenic long-term facilitation (pLTF), a form of spinal respiratory neuroplasticity resulting in increased phrenic nerve motor output following exposure to acute intermittent hypoxia (aIH; three 5 min episodes, 10.5% O2). Despite the importance of respiratory system neuroplasticity, and its dependence on estrogen in males, little is known about pLTF expression or mechanisms of estrogen signaling in females. Here, we tested the hypotheses that (1) pLTF expression in young, gonadally intact female rats would be expressed during estrous cycle stages in which 17β-estradiol (E2) is naturally high (e...
July 12, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28578120/intraspinal-pressure-monitoring-and-extensive-duroplasty-in-the-acute-phase-of-traumatic-spinal-cord-injury-a-systematic-review
#14
REVIEW
Tykocki Tomasz, Lukasz Poniatowski, Marcin Czyz, Michael Koziara, Guy Wynne-Jones
The prognosis in cervical spinal cord injury (SCI) is poor and surgical and neuro intensive care management need further improvement. Monitoring of the intraspinal pressure (ISP) at early stage after tSCI is clinically useful. Obtaining continuous spinal cord perfusion pressure (SCPP) measurements based on the difference between mean arterial pressure (MAP) and ISP allows offering best medical and surgical treatment during this critical phase of tSCI. The optimal SCPP was found to be between 90-100mmHg and MAP of 110-130...
May 31, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28570271/delayed-decompression-exacerbates-ischemia-reperfusion-injury-in-cervical-compressive-myelopathy
#15
Pia M Vidal, Spyridon K Karadimas, Antigona Ulndreaj, Alex M Laliberte, Lindsay Tetreault, Stefania Forner, Jian Wang, Warren D Foltz, Michael G Fehlings
Degenerative cervical myelopathy (DCM) is the most common progressive nontraumatic spinal cord injury. The most common recommended treatment is surgical decompression, although the optimal timing of intervention is an area of ongoing debate. The primary objective of this study was to assess whether a delay in decompression could influence the extent of ischemia-reperfusion injury and alter the trajectory of outcome in DCM. Using a DCM mouse model, we show that decompression acutely led to a 1.5- to 2-fold increase in levels of inflammatory cytokines within the spinal cord...
June 2, 2017: JCI Insight
https://www.readbyqxmd.com/read/28555661/risk-factors-for-severe-dysphagia-in-acute-cervical-spinal-cord-injury
#16
T Hayashi, Y Fujiwara, H Sakai, T Maeda, T Ueta, K Shiba
STUDY DESIGN: A retrospective, consecutive case series. OBJECTIVES: The relationship between dysphagia and acute cervical spinal cord injury (CSCI) has been recently reported; however, the cause and mechanism of dysphagia are still not well understood. No definitive factors have yet been established according to multivariate analysis. The objective is to elucidate the incidence and risk factors of dysphagia in patients with acute CSCI. SETTING: Spinal Injuries Center, Fukuoka, Japan...
May 30, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28537458/chiari-i-malformation-in-children-with-transverse-myelitis
#17
Sathya Vadivelu, Sudhakar Vadivelu, Maureen Mealy, Smurti Patel, Libby Kosnik-Infinger, Daniel Becker
PURPOSE: Transverse myelitis (TM) is an acute inflammatory spinal cord injury. Asymptomatic Chiari I malformation (CMI) management is highly controversial, particularly when associated with a spinal syrinx. Here, we assess the occurrence of CMI in the pediatric TM population and management outcomes. METHODS: We performed a retrospective cohort study based on 61 consecutively identified pediatric TM cases over an -8-year period. We reviewed demographic characteristics, radiographic findings, presenting symptoms, and long-term outcomes...
May 24, 2017: Developmental Neurorehabilitation
https://www.readbyqxmd.com/read/28501580/can-the-acute-magnetic-resonance-imaging-features-reflect-neurologic-prognosis-in-patients-with-cervical-spinal-cord-injury
#18
Akinobu Matsushita, Takeshi Maeda, Eiji Mori, Itaru Yuge, Osamu Kawano, Takayoshi Ueta, Keiichiro Shiba
BACKGROUND CONTEXT: Several prognostic studies looked for an association between the degree of spinal cord injury (SCI), as depicted by primary magnetic resonance imaging (MRI) within 72 hours of injury, and neurologic outcome. It was not clearly demonstrated whether the MRI at any time correlates with neurologic prognosis. PURPOSE: The purpose of the present study was to investigate the relationship between acute MRI features and neurologic prognosis, especially walking ability of patients with cervical spinal cord injury (CSCI)...
May 10, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28469668/anesthetic-considerations-for-patients-with-acute-cervical-spinal-cord-injury
#19
REVIEW
Fang-Ping Bao, Hong-Gang Zhang, Sheng-Mei Zhu
Anesthesiologists work to prevent or minimize secondary injury of the nervous system and improve the outcome of medical procedures. To this end, anesthesiologists must have a thorough understanding of pathophysiology and optimize their skills and equipment to make an anesthesia plan. Anesthesiologists should conduct careful physical examinations of patients and consider neuroprotection at preoperative interviews, consider cervical spinal cord movement and compression during airway management, and suggest awake fiberoptic bronchoscope intubation for stable patients and direct laryngoscopy with manual in-line immobilization in emergency situations...
March 2017: Neural Regeneration Research
https://www.readbyqxmd.com/read/28437499/systemic-hypothermia-as-treatment-for-an-acute-cervical-spinal-cord-injury-in-a-professional-football-player-9-year-follow-up
#20
Andrew Cappuccino, Leslie J Bisson, Bud Carpenter, Ken Snyder, Helen Cappuccino
The following report provides clinical follow-up on a National Football League player who sustained a complete cervical spinal cord injury (SCI) while tackling an opposing player in 2007. He received prompt medical and surgical care based on then-current recommendations, but was also treated with systemic hypothermia soon after his injury, which was controversial at the time. Since then, smaller randomized human studies have described the tolerable safety profile, efficacy, and potential benefits of this intervention in acute SCI in humans...
March 2017: American Journal of Orthopedics
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