About Traumatic Spinal Cord Injury & Brain Injury

on Sunday, May 17, 2009


Traumatic Spinal Cord Injury (TSCI)

-is a low-incidence, high-cost disability requiring tremendous changes in an individual's lifestyle. Divided into two- traumatic injuries and nontraumatic damage.

Traumatic injuries caused of accidents involving motor vehicles (45.6%), falls (19.6%), acts of violence (17.8%), recreational sports injuries (10.7%) and other (6.3%).

NonTraumatic damage caused of disease or pathological influence such as vascular malfunctions (arteriovenous malformation (AVM), thrombosis, embolus, or hemorrhage), vertebral subluxations secondary to rheumatoid arthritis or degenerative joint disease, infections such as syphilis or tranverse myelitis, spinal neoplasms, syringomyelia, abscesses of the spinal cord and neurological diseases such as multiple sclerosis and amyotrophic lateral sclerosis.

Two functional categories- Tetrapelgia and Paraplegia.

Tetrapelgia- complete paralysis of all four extremities and trunk, including the respiratory muscles, and results from lesions of the cervical cord.

Paraplegia- complete paralysis of all or part of trunk and both lower extremities, resulting from lesions of the thoracic or lumbar spinal cord or cauda equina.

Impairment Scale- ASIA ( American Spinal Cord Injury Association) Impairment scale:

ASIA A- Complete- No motor or sensory functions is preserved in the sacral segments Sacral 4 (S4) to Sacral 5 (S5)

ASIA B- Incomplete- Sensory but not motor function is preserved below the neurological level and includes the sacral segments S4 to S5

ASIA C- Incomplete- Motor function is preserved below the neurological level, and more than half of key muscles below the neurological level have a muscle grade less than 3

ASIA D- Incomplete- Motor function is preserved below the neurological level, and at least half of key muscles below the neurological level have a muscle grade of 3 or more.

ASIA E- Normal- Motor and sensory function is normal.

Traumatic Brain Injury (TBI)

- The patient with TBI is treated across a wide continuum of care, which includes hospitalization, rehabiltaion centers, community reentry programs, outpatient therapy, schools, vocational rehabilitation and assisted living centers.

-Cause- motor vehicles accidents (50%), falls (25%) , assaults and violence (15%) and sports & recreation (10%).
- Men are injured more often than woman.
- Ages 15-25 years old.

- The economic impact of TBI is substantial, for both the individual and society. For examples in The United States- annual cost of acute care and rehabilitation for new brain injuries is about 9-10 billion.

- Because there is no cure for a brain injury, it is important that health care professionals become involved in preventative measures. This may involve community outreach and education hifh-risk groups, particularly teenagers.

Source: Susan B & Thomas J: Physical Rehabilitation, 5th Edition, 2007,
F.A Davis Company, Philadelphia.