Traumatic brain injury is under-diagnosed in patients with spinal cord injury.
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.
Tolonen
Anu
A
Käpylä Rehabilitation Centre, Finnish Association of People with Mobility Disabilities, Helsinki, Finland. anu.tolonen@invalidiliitto.fi
Turkka
Jukka
J
Salonen
Oili
O
Ahoniemi
Eija
E
Alaranta
Hannu
H
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