Skip to main content

Concurrent Traumatic Brain Injury with Spinal Cord Injury

  • Chapter
  • First Online:
Management and Rehabilitation of Spinal Cord Injuries
  • 1213 Accesses

Abstract

The reported incidence of concomitant brain and spinal cord injuries varies from 25% to more than 60%, depending on the criteria used, especially when the injury mechanism is a motor vehicle collision or a fall. Other factors that increase the risk for a concomitant traumatic brain injury are cervical level spinal cord injury, complete spinal cord injury, and trauma associated with alcohol intoxication. The highest rate of traumatic brain injury occurs in patients with spinal cord injury with C1–C4 levels of injury. There should be increased suspicion for concomitant traumatic brain injury when examining the epidemiology of spinal cord injury caused by high-velocity impact and rapid deceleration events such as motor vehicle accidents. Concurrent traumatic brain injury is evidenced by a history of loss of consciousness; impaired Glasgow Coma Scale that assesses eye opening, verbal response, and best motor response; and/or imaging abnormalities.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Chew E, Zafonte RD. Pharmacological management of neurobehavioral disorders following traumatic brain injury—a state-of-the-art review. J Rehabil Res Dev. 2009;46(6):851–79.

    Article  Google Scholar 

  • Harrigan MR. Cerebral salt wasting syndrome. Crit Care Clin. 2001;17(1):125–38.

    Article  CAS  Google Scholar 

  • Inoue T, Lin A, Ma X, et al. Combined SCI and TBI: recovery of forelimb function after unilateral cervical spinal cord injury (SCI) is retarded by contralateral traumatic brain injury (TBI), and ipsilateral TBI balances the effects of SCI on paw placement. Exp Neurol. 2013;248:136–47.

    Article  Google Scholar 

  • Kirshblum S, Johnston MV, Brown J, et al. Predictors of dysphagia after spinal cord injury. Arch Phys Med Rehabil. 1999;80(9):1101–5.

    Article  CAS  Google Scholar 

  • Kushner DS. Strategies to avoid a missed diagnosis of co-occurring concussion in post-acute patients having a spinal cord injury. Neural Regen Res. 2015;10(6):859–61.

    Article  Google Scholar 

  • Kushner DS, Alvarez G. Dual diagnosis: traumatic brain injury with spinal cord injury. Phys Med Rehabil Clin N Am. 2014;25(3):681–96.

    Article  Google Scholar 

  • Lohani S, Devkota UP. Hyponatremia in patients with traumatic brain injury: etiology, incidence, and severity correlation. World Neurosurg. 2011;76(3–4):355–60.

    Article  Google Scholar 

  • Macciocchi S, Seel RT, Thompson N, et al. Spinal cord injury and cooccurring traumatic brain injury: assessment and incidence. Arch Phys Med Rehabil. 2008;89:1350–7.

    Article  Google Scholar 

  • Mackay LE, Morgan AS, Bernstein BA. Swallowing disorders in severe brain injury: risk factors affecting return to oral intake. Arch Phys Med Rehabil. 1999a;80(4):365–71.

    Article  CAS  Google Scholar 

  • Mackay LE, Morgan AS, Bernstein BA. Factors affecting oral feeding with severe traumatic brain injury. J Head Trauma Rehabil. 1999b;14(5):435–47.

    Article  CAS  Google Scholar 

  • Moro N, Katayama Y, Igarashi T, et al. Hyponatremia in patients with traumatic brain injury: incidence, mechanism, and response to sodium supplementation or retention therapy with hydrocortisone. Surg Neurol. 2007;68(4):387–93.

    Article  Google Scholar 

  • Neurobehavioral Guidelines Working Group, Warden DL, Gordon B, et al. Guidelines for the pharmacologic treatment of neurobehavioral sequelae of traumatic brain injury. J Neurotrauma. 2006;23(10):1468–501.

    Article  Google Scholar 

  • Saboe LA, Reid DL, Davis LA, et al. Spinal trauma and associated injuries. J Trauma. 1991;31:43–8.

    Article  CAS  Google Scholar 

  • Sommer JL, Witkiewicz PM. The therapeutic challenges of dual diagnosis: TBI/SCI. Brain Inj. 2004;18:1297–308.

    Article  Google Scholar 

  • Tian W, Yu J. The role of C2-C7 angle in the development of dysphagia after anterior and posterior cervical spine surgery. Clin Spine Surg. 2017;30(9):E1306–14.

    Article  Google Scholar 

Suggested Reading

  • Afifi AK, Bergman RA. Functional neuroanatomy: text and atlas. 2nd ed. New York: Lange Medical Books/McGraw-Hill; 2005.

    Google Scholar 

  • American Spinal Injury Association, editor. International standards for neurological classification of spinal cord injury. Revised 2011. Updated 2015 ed. Atlanta: American Spinal Injury Association; 2015.

    Google Scholar 

  • Campbell WW. DeJong’s the neurologic examination. 7th ed. New York: Wolters Kluwer Lippincott Williams & Wilkins; 1992.

    Google Scholar 

  • Cardenas DD, Dalal K, editors. Spinal cord injury rehabilitation. Physical Medicine and Rehabilitation Clinics of North America. Philadelphia, PA: Elsevier; 2014.

    Google Scholar 

  • Cardenas DD, Hooton TM, editors. Medical complications in physical medicine and rehabilitation. New York: Demos Medical Publishing, LLC; 2015.

    Google Scholar 

  • Chhabra HS, editor. ISCoS textbook on comprehensive management of spinal cord injuries. New Delhi: Wolters Kluwer; 2015.

    Google Scholar 

  • Crossman A, Neary D. Neuroanatomy: an illustrated colour test. 5th ed. Philadelphia, PA: Elsevier; 2015.

    Google Scholar 

  • Felten DL, O’Banion MK, Maida MS. Netter’s atlas of neuroscience. 3rd ed. London: Elsevier; 2016.

    Google Scholar 

  • Green D, editor. Medical management of long-term disability. 2nd ed. Boston, MA: Butterworth-Heinemann; 1996.

    Google Scholar 

  • Kirshblum S, Campagnolo DI, editors. Spinal cord medicine. 2nd ed. Philadelphia, PA: Wolters Kluwer, Lippincott, Williams & Wilkins; 2011.

    Google Scholar 

  • Mtuid E, Gruener G, Dockery P. Fitzgerald’s clinical neuroanatomy and neuroscience. 7th ed. Philadelphia, PA: Elsevier; 2016.

    Google Scholar 

  • Neuburger M. The historical development of experimental brain and spinal cord physiology before Flourens. Baltimore, MD: The Johns Hopkins University Press; 1981.

    Google Scholar 

  • Passias PG, editor. Cervical myelopathy. Philadelphia, PA: Jaypee Brothers Medical Publishers (P) Ltd; 2016.

    Google Scholar 

  • Preston RA. Acid-base, fluids and electrolytes: made ridiculously simple. 2nd ed. Miami: MedMaster, Inc.; 2011.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Ko, HY. (2019). Concurrent Traumatic Brain Injury with Spinal Cord Injury. In: Management and Rehabilitation of Spinal Cord Injuries. Springer, Singapore. https://doi.org/10.1007/978-981-10-7033-4_34

Download citation

  • DOI: https://doi.org/10.1007/978-981-10-7033-4_34

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-10-7032-7

  • Online ISBN: 978-981-10-7033-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics