Abstract
The complete medical records of 122 patients who sustained traumatic spinal cord injuries were reviewed to determine the frequency and results of emergency room assessments for loss of consciousness (LOC) and post-traumatic amnesia (PTA). Eighty-eight percent of the patients were assessed for LOC and 19% were assessed for PTA. Fifty patients (41% of the total population) admitted to LOC, PTA or both. Fourteen of these 50 patients underwent subsequent radiographic examinations of the skull, all of which were negative. Because of the association of intracranial complications and long-term cognitive sequelae with even brief LOC or PTA, early recognition of craniocerebral trauma is an important component of the acute management of spinal cord injured patients.
Similar content being viewed by others
Article PDF
References
Bell R S, Loop J W 1971 The utility and futility of radiographic skull examinations for trauma. New England Journal of Medicine 284: 236–239.
Braakman R 1972 Depressed skull fracture: Data, treatment, and follow-up in 225 consecutive cases. Journal of Neurology, Neurosurgery and Psychiatry 35: 395–400.
DeLacey G, Guilding A, Wignall B, et al. 1980 Mild head injuries: A source of excessive radiography? (Analysis of a series and reivew of the literature). Clinical Radiology 31: 457–462.
Denny-Brown D 1945 Disability arising from closed head injury. Journal of American Medical Association 127: 429–436.
Dikman S, Reitan R M 1977 Emotional sequelae of head injury. Annals of Neurology 2: 492–494.
Dubo H, Delaney G 1984 101 spinal cord injuries due to motor vehicle accidents. Proceedings of the American Spinal Injury Association. pp. 35–38.
FDA Drug Bulletin. 1978 8: 30–31.
Fordyce D J, Roueche J R, Prigatano G P 1983 Enhanced emotional reactions in chronic head trauma patients. Journal of Neurology, Neurosurgery and Psychiatry 46: 620–624.
French B N, Dublin A B 1977 The value of computerized tomography in the management of 1000 consecutive head injuries. Surgical Neurology 7: 171–183.
Galbraith S L 1973 Age distribution of extradural haemorrhage without skull fracture. Lancet 1: 1217–1218.
Galbraith S L, Smith J 1976 Acute traumatic intracranial haematoma without skull fracture. Lancet 1: 501–503.
Gronwall D, Wrightson, P 1974 Delayed recovery of intellectual function after minor head injury. Lancet 2: 605–609.
Guttmann L 1963 Proceedings of Symposium on spinal injuries, p. 81, Roy Coll Surg: Edinburgh.
Harris P 1968 Associated injuries in traumatic paraplegia and tetraplegia. Paraplegia 5: 215–220.
Jennett B 1980 Skull x-rays after recent head injury. Clinical Radiology 31: 463–469.
Jennett B, Miller J D 1972 Infection after depressed fracture of skull: Implications for management of non-missile injuries. Journal of Neurosurgery 36: 333–340.
Levin H S, Grossman R G 1978 Behavioural sequelae of closed head injury: A quantitative study. Archives of Neurology 35: 720–727.
Lishman W A 1973 The psychiatric sequelae of head injury: A review. Psychological Medicine 3: 304–318.
Meinecke F W 1968 Frequency and distribution of associated fractures in traumatic paraplegia and tetraplegia. Paraplegia 5: 196–211.
Midwest Regional Spinal Cord Injury Center 1980 Report No. 9, Northwestern University-McGraw Medical Centre, Chicago.
Miller J D, Jennett, B 1968 Complications of depressed skull fracture. Lancet 2: 991–995.
Rimel R W, Giordani B, Barth J T, et al. 1981 Disability caused by minor head injury. Neurosurgery 9: 221–228.
Russell W R 1932 Cerebral involvement in head injury. Brain 55: 549–603.
Russell W R, Smith A 1961 Post-traumatic amnesia in closed head injury. Archives of Neurology 5: 4–17.
Schueneman A, Morris J 1982 Neuropsychological deficits associated with SCI. SCI Digest 4: 35–64.
Silver J R, Morris W R, Otfinowski J S 1980 Associated injuries in patients with spinal injury. Injury 12: 219–224.
Smith A 1961 Duration of impaired consciousness as an index of severity in closed head injury: A review. Dis Nerv Syst 22: 69–74.
Steadman J H, Graham J G 1970 Head injuries: An analysis and follow-up study. Proceedings of the Royal Society of Medicine 63: 23–28.
Strang I, MacMillan R, Jennett, B 1978 Head injuries in accident and emergency departments at Scottish hospitals. Injury 10: 154–159.
VonWowern F F 1966 Post-traumatic amnesia and confusion as an index of severity in head injury. Acta Neurologica Scandinavica 42: 373–378.
Wagner K A, Kopaniky D R, Esposito L 1984 Combined head and spinal cord injury: Potential for errors in diagnosis and treatment. Proceedings of the American Spiral Injury Association, pp. 96–104.
Wilmot C B, Cope D N, Hall K M, et al. 1984 Incidence of occult head injury in those with a primary diagnosis of spinal cord injury. Proceedings of the American Spinal Injury Association, pp. 105–108.
Young J S, Burns P E, Bowen A M, et al. 1982 Spinal cord injury statistics: Experience of the regional spinal injury sytems, p. 34, Good Samaritan Medical Centre, Phoenix.
Author information
Authors and Affiliations
Additional information
Read at the Annual Scientific Meeting of the International Medical Society of Paraplegia, Denver, Colorado. June, 1984; and at the 14th UAEM Annual Meeting, Louisville, Kentucky. May, 1984.
Rights and permissions
About this article
Cite this article
Davidoff, G., Roth, E., Morris, J. et al. Assessment of closed head injury in trauma-related spinal cord injury. Spinal Cord 24, 97–104 (1986). https://doi.org/10.1038/sc.1986.13
Issue Date:
DOI: https://doi.org/10.1038/sc.1986.13