title: Traumatic brain injury is under-diagnosed in patients with spinal cord injury.
abstract: OBJECTIVE
  To investigate the occurrence and severity of traumatic brain injury in patients with traumatic spinal cord injury.
  
  
  METHODS
  Cross-sectional study with prospective neurological, neuropsychological and neuroradiological examinations and retrospective medical record review.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors: Käpylä Rehabilitation Centre, Finnish Association of People with Mobility Disabilities, Helsinki, Finland. anu.tolonen@invalidiliitto.fi
authors: Anu
authors: A
authors: Tolonen
authors: Jukka
authors: J
authors: Turkka
authors: Oili
authors: O
authors: Salonen
authors: Eija
authors: E
authors: Ahoniemi
authors: Hannu
authors: H
authors: Alaranta
mesh_terms: D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000150:complications* / Q000175:diagnosis / Q000534:rehabilitation; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D011446:Prospective Studies; D013119:Spinal Cord Injuries / Q000150:complications* / Q000534:rehabilitation