title: Traumatic spinal cord injury and concomitant brain injury: a cohort study.
abstract: OBJECTIVE
  To assess the temporal trends in the incidence and demographic characteristics of traumatic spinal cord injury (TSCI) with clinical concomitant traumatic brain injury (TBI), in an unselected, geographically defined cohort, 1952-2001.
  
  
  METHODS
  The patients were identified from hospital records. TBI was classified as none, mild, moderate, and severe.
  
  
  RESULTS
  Of 336 patients, 157 (46.7%) patients had a clinical concomitant TBI. Clinical TBI was classified as mild in 30.1%, moderate in 11.0% and severe in 5.7%. The average annual incidence increased from 3.3 per million in the first decade to 10.7 per million in the last. Alcohol was the strongest risk factor of clinical TBI (OR = 3.69) followed by completeness of TSCI (OR = 2.18).
  
  
  CONCLUSIONS
  The incidence of TSCI with concomitant TBI has increased during the last 50 years. Alcohol and completeness of injury are strong risk factors. Increased awareness of dual diagnoses is necessary.
authors.affiliation: Department of Neurology, Haukeland University Hospital, Bergen, Norway. ellen.merete.hagen@helse-bergen.no
authors.forename: E M
authors.initials: EM
authors.lastname: Hagen
authors.forename: G E
authors.initials: GE
authors.lastname: Eide
authors.forename: T
authors.initials: T
authors.lastname: Rekand
authors.forename: N E
authors.initials: NE
authors.lastname: Gilhus
authors.forename: M
authors.initials: M
authors.lastname: Gronning
mesh_terms: D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000453:epidemiology*; D055815:Young Adult