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29 - Spinal Cord Injury

from SECTION IV - NEUROLOGICAL TRAUMA

Published online by Cambridge University Press:  06 August 2009

Charles H. Bill
Affiliation:
Sparrow Healthcare System Lansing, Michigan
Vanessa L. Harkins
Affiliation:
Sparrow Helthcare System Sparrow Hospital/MSU Emergency Medicine residency Program Lansing, Michigan
Sid M. Shah
Affiliation:
Michigan State University
Kevin M. Kelly
Affiliation:
Drexel University, Philadelphia
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Summary

Spinal cord injuries at or above the C4 level can result in respiratory compromise. When the level of injury is just below the origins of the phrenic nerves, intercostal muscle function is lost, and the patient can be completely dependent on diaphragmatic contraction for respiration. Various degrees of transient neurological disability may occur as a result of a phenomenon known as spinal shock. Spinal shock results from physiological transection of the spinal cord, which commonly lasts 24-48 hours. Acute cervical strain is the most common injury following a vehicular accident. Injuries to the carotid and vertebral arteries and jugular veins are commonly associated with spinal cord injuries caused by gun shot wounds. The Third National Acute Spinal Cord Injury Randomized Controlled Trial (NASCIS III) concluded that high-dose methylprednisolone administration is associated with improved neurological outcome in spinal cord-injured patients. Spinal cord injuries are rare in patients under 17 years old.
Type
Chapter
Information
Principles and Practice of Emergency Neurology
Handbook for Emergency Physicians
, pp. 286 - 303
Publisher: Cambridge University Press
Print publication year: 2003

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References

Hurlbert, R J. Methylprednisolone for acute spinal cord injury: an inappropriate standard of care. J Neurosurg. 2000; 93: 1–7Google ScholarPubMed
Nesathurai, S. Steroids and spinal cord injury: revisiting the NASCIS 2 and NASCIS 3 trials. J Trauma. 1998; 45: 1088–93CrossRefGoogle ScholarPubMed

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  • Spinal Cord Injury
    • By Charles H. Bill, Sparrow Healthcare System Lansing, Michigan, Vanessa L. Harkins, Sparrow Helthcare System Sparrow Hospital/MSU Emergency Medicine residency Program Lansing, Michigan
  • Edited by Sid M. Shah, Michigan State University, Kevin M. Kelly, Drexel University, Philadelphia
  • Book: Principles and Practice of Emergency Neurology
  • Online publication: 06 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547256.030
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  • Spinal Cord Injury
    • By Charles H. Bill, Sparrow Healthcare System Lansing, Michigan, Vanessa L. Harkins, Sparrow Helthcare System Sparrow Hospital/MSU Emergency Medicine residency Program Lansing, Michigan
  • Edited by Sid M. Shah, Michigan State University, Kevin M. Kelly, Drexel University, Philadelphia
  • Book: Principles and Practice of Emergency Neurology
  • Online publication: 06 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547256.030
Available formats
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Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Spinal Cord Injury
    • By Charles H. Bill, Sparrow Healthcare System Lansing, Michigan, Vanessa L. Harkins, Sparrow Helthcare System Sparrow Hospital/MSU Emergency Medicine residency Program Lansing, Michigan
  • Edited by Sid M. Shah, Michigan State University, Kevin M. Kelly, Drexel University, Philadelphia
  • Book: Principles and Practice of Emergency Neurology
  • Online publication: 06 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547256.030
Available formats
×