Traumatic brain injury is under-diagnosed in patients with spinal cord injury

J Rehabil Med. 2007 Oct;39(8):622-6. doi: 10.2340/16501977-0101.

Abstract

Objective: To investigate the occurrence and severity of traumatic brain injury in patients with traumatic spinal cord injury.

Design: Cross-sectional study with prospective neurological, neuropsychological and neuroradiological examinations and retrospective medical record review.

Patients: Thirty-one consecutive, traumatic spinal cord injury patients on their first post-acute rehabilitation period in a national rehabilitation centre.

Methods: The American Congress of Rehabilitation Medicine diagnostic criteria for mild traumatic brain injury were applied. Assessments were performed with neurological and neuropsychological examinations and magnetic resonance imaging 1.5T.

Results: Twenty-three of the 31 patients with spinal cord injury (74%) met the diagnostic criteria for traumatic brain injury. Nineteen patients had sustained a loss of consciousness or post-traumatic amnesia. Four patients had a focal neurological finding and 21 had neuropsychological findings apparently due to traumatic brain injury. Trauma-related magnetic resonance imaging abnormalities were detected in 10 patients. Traumatic brain injury was classified as moderate or severe in 17 patients and mild in 6 patients.

Conclusion: The results suggest a high frequency of traumatic brain injury in patients with traumatic spinal cord injury, and stress a special diagnostic issue to be considered in this patient group.

MeSH terms

  • Adolescent
  • Adult
  • Brain Injuries / complications*
  • Brain Injuries / diagnosis
  • Brain Injuries / rehabilitation
  • Cross-Sectional Studies
  • Female
  • Humans
  • Injury Severity Score
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neurologic Examination
  • Neuropsychological Tests
  • Prospective Studies
  • Spinal Cord Injuries / complications*
  • Spinal Cord Injuries / rehabilitation