Spinal cord injuries
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Central cord syndrome results in greater motor deficit in the upper extremities than the lower extremities. It is often caused by hyperextension injuries or cervical osteophytic spurs and presents with weakness in the upper extremities and varying sensory deficits below the level of injury. Treatment involves ICU management to support respiratory and cardiac function, maintaining mean arterial pressure above 85-90 mmHg for spinal cord perfusion, and surgical decompression if there is instability or persistent cord compression.
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Spinal cord injury results in loss of function below the site of damage. Common causes include vehicle accidents, falls, and sports injuries. Complete injuries result in total loss of sensation and movement below the injury, while incomplete injuries allow some sensation or movement. Management involves immobilization, surgery to decompress the spine, and rehabilitation to regain function. Nursing care focuses on preventing complications like pressure ulcers, respiratory issues, and autonomic dysreflexia.
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2. Initial evaluation involves stabilizing the patient with a cervical collar and assessing for neurological deficits. Imaging such as X-rays and CT/MRI are used to classify fractures and guide treatment.
3. Treatment depends on the fracture type but may involve halo immobilization, surgery to stabilize fractures or decompress the spinal cord, or bracing for stable injuries. The goal is to restore spinal alignment and prevent further neurological injury.
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This document provides an overview of paraplegia in children, including definitions, causes, classifications, clinical features, investigations, and management. Paraplegia is defined as impairment of motor function in the lower extremities, which can be spastic or flaccid depending on whether it involves the upper or lower motor neurons. Causes include cerebral, spinal, infectious, inflammatory, demyelinating, hereditary, toxic, vascular, metabolic, tropical, and paraneoplastic conditions. Clinical assessment involves detailed neurological examination and investigations include imaging of the brain and spine as well as other tests depending on suspected etiology. Management involves addressing the underlying cause, rehabilitation, and preventing/treating complications.
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Central cord syndrome
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Developmental dysplasia of the hip (DDH) is a spectrum of hip disorders that can occur from conception to skeletal maturity. It most commonly affects females and risk factors include genetic predisposition, breech positioning, and hormonal influences. Clinical features include limb asymmetry and limited hip movement. Diagnosis involves clinical tests and imaging like ultrasound or X-rays. Management depends on age, with splinting often used for young infants and closed or open reduction with spica casting for older children. Complications can include limping, osteoarthritis, or avascular necrosis if left untreated.
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- Causes, signs and symptoms, assessment, diagnostic tests, and management including medical, surgical, and nursing considerations.
- Potential complications are also discussed such as autonomic dysreflexia, pressure sores, and loss of bladder/bowel control. Rehabilitation strategies aim to improve mobility and independence.
Spinal cord injury
Spinal cord injury is a low incidence, high cost disability requiring tremendous changes in an individual’s lifestyle
Tetraplegia - lesion
Paraplegia - lesion
Spinal Cord Injuries
This document provides information about spinal cord injuries. It begins with definitions of spinal cord injury and discusses the incidence, causes, types, and mechanisms of injury. The types include complete vs incomplete injuries such as central cord syndrome, Brown-Sequard syndrome, and anterior cord syndrome. Clinical manifestations, diagnostic evaluation, complications, treatment, nursing management, and rehabilitation are outlined. Surgical management and various nursing diagnoses related to spinal cord injury are also mentioned.
Spinal cord injury
1) Spinal cord injury can occur from trauma such as motor vehicle accidents, falls, or violence. It results in loss of movement and sensation below the site of injury.
2) Injuries can be complete or incomplete. Complete injuries result in total loss of function below the injury while incomplete injuries cause mixed losses.
3) Common complications include respiratory issues, pressure ulcers, blood clots, and autonomic dysreflexia. Management involves steroids, surgery, and preventative care measures.
Cervical spine injury
1. The document discusses the anatomy, mechanisms of injury, classification, clinical features, management, and imaging of cervical spine injuries.
2. Key points include the importance of manual handling and immobilization of patients with potential cervical spine injuries. Radiographic imaging including CT and MRI are important diagnostic tools.
3. Common cervical spine injuries include fractures of C1 (Atlas) and C2 (Axis) as well as fracture-dislocations. Clinical syndromes can occur based on the level and mechanism of injury.
Spinal cord injury (SCI)
A spinal cord injury (SCI) is damage to the spinal cord that causes temporary or permanent changes in its function. Symptoms may include loss of muscle function, sensation, or autonomic function in the parts of the body served by the spinal cord below the level of the injury.
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Peripheral Nerve Injury (Part-I)
This document provides an overview of peripheral nerve injuries. It discusses the anatomy of peripheral nerves and their formation from spinal nerves. Common mechanisms of peripheral nerve injury are described, including fracture, laceration, burns, and compression. The process of neuronal degeneration and regeneration after injury is explained. Seddon's and Sunderland's classifications of nerve injuries based on the severity of injury are introduced. Finally, the document begins to describe specific regional nerve injuries, focusing on injuries to the brachial plexus, radial nerve, median nerve, and injuries causing "wrist drop" and "finger drop".
Final case presentation sci (kimberly walsh)
This document provides an overview of cervical myelopathy and spinal cord injury, including:
- Definitions of spinal cord injury and cervical myelopathy.
- Descriptions of anatomy including the spine, cervical spine, intervertebral discs, and ligaments.
- Causes, pathophysiology, and clinical manifestations of both cervical myelopathy and spinal cord injury.
- Details on epidemiology, diagnosis, complications and management of spinal cord injury.
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Spinal cord injuries
- 1. SPINAL CORD injuries Mohamed Elsayed Elsebaey Neurosurgery Registrar Egypt, Ismailia Ministry of Health Seba3y700025@gmail.com Mohamed E Elsebaey
- 5. ASIA Impairment Scale • A ____ complete : no motor or sensory function preserved • B ____ incomplete: sensory preserved, but no motor function preserved • C ____ incomplete: motor preserved, grade< 3 • D ____ incomplete: motor preserved, grade>3 • E ____ normal: sensory & motor normal
- 6. SPINAL CORD INJURY • COMPLETE • INCOMPLETE
- 7. Incomplete • Central cord syndrome • Anterior cord syndrome • Brown sequard cord syndrome • Posterior cord syndrome
- 8. Central cord syndrome • Greater motor deficit in UE than LE . • Hyperextension injury ___ osteophytic spurs . • History of blow, RTA, fall . • Occur With or with out cervical fracture or dislocation
- 9. Patho-mechanics • most center region of the spinal cord is vascular watershed zone. • Suscepatible to injury from edema. • Cervical fibres are located more medially than fibres serving the LE .
- 11. CCSPresented by • Motor : weakness in UE , lesser effect on LE. • Sensory : varying degrees below level of lesion • Myelopathic : sphincter dysfunction ( urinary retention )
- 12. Natural history • Initial phase of improvement characterized by, LE recover 1st , Bladder function next , UE strength returns with Finger movement last Pt is able to walk with assistance within 5 days. Recovery is usually incomplete & related to the injury.
- 13. Evaluated by • Cervical spine x ray • CT scan • MRI • Congenital narrowing,osteophtic spurs,# dislocation, traumatic disc herniaton, cord edema, & hematomyelia
- 14. Treatment • ICU management ___ cardiac, respiratory, hemodynamic monitoring . • MAP 85 --- 90 mmHg ____ spinal cord perfusion • Reduction of fracture dislocation • Surgical decompression, when ?? For instability of the spine and persistent compression of the cord that correlates with the level of deficit.
- 15. Anterior cord syndrome • AKA anterior spinal artery syndrome • Cord infarction in the region supplied by the ant. Spinal artery so, it results from compression or occlusion .
- 17. Presented by • Paraplegia , if lesion higher C7 Quadriplegia may presented. • Sensory : A _ loss of pain and temperature B _ post. Column function preserved, postion sense , deep pressure sense.
- 18. Evaluated by • Myelography • CT • MRI to differentiate non surgical condition ( occlusion ) from surgical one ( bone fragment ) . Worst prognosis .
- 19. Brown sequard syndrome We can say spinal cord hemisection . Penetration trauma, Radiation myelopathy , Cord compression by Spinal epidural hematoma , large cervical herniation, spinal cord tumour & spinal AVM
- 21. Prognosis Best prognosis of any ISCI About 90% of pts recover and regain anal and urinary sphincter control .
- 22. Complete spinal cord injury
- 23. Presented by , • Loss of voluntary movement sphincter control sensation below level of injury. Priapism , Bradycardai, Hypotension in case of spinal shock.
- 24. N.B. If the patient come in the ER , I do 1st the ( A, B, C, D ) protocol and cervical region stability, then do the neurological assessment.
- 25. THANKS