Acute Spinal Cord Injury (Trauma)
Next Steps
Acute Spinal Cord Injuries are treated at Upstate Brain and Spine Center.
Definition
Trauma is a serious injury or shock to the body. It can affect a person's ability to function. Sometimes it can be fatal. It needs to be treated right away.
Brain Trauma from Whiplash |
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Causes
Some causes of trauma include:
- Accidents, such as:
- Motor vehicle crashes
- Falls
- Plane crashes
- Near-drowning
- Physical assault—such as attacks, gunshots, stabbing, or rape
- Burns and electrical shocks
- Natural disasters—such as fires, floods, earthquakes, or lightning
- Animal attacks
- Contact sports
- Explosions
Risk Factors
Trauma is more common in people aged 1 to 44 years. Other things that raise the risk are:
- Lack of car or boat safety, such as:
- Drinking alcohol while driving
- Using a cell phone, texting, or being distracted while driving
- Not wearing a seatbelt or a lifejacket
- Not using a child safety seat properly
- Improper use or storage of firearms
- Unsafe home conditions such as:
- Objects or conditions that lead to falls
- Not using smoke detectors or not changing dead batteries
- Not wearing proper protection—while playing sports or using dangerous equipment
- Improper use of dangerous machinery
- Fighting with fists or weapons—especially after drinking alcohol
- Lack of water safety, such as:
- Swimming alone or without previous lessons
- Not watching a child while they are swimming
- Improper fencing or locks around swimming pools
- Approaching an animal unsafely or aggressively
Symptoms
Symptoms depend on the type or extent of injuries. They may include:
- Pain
- Bleeding
- Breathing problems
- Headache, nausea, vomiting, amnesia, or altered mental status
- Deformity from broken bones
- Loss of feeling and/or muscle strength
- Problems urinating or passing stool
- Loss of consciousness or coma
Emotional symptoms may be:
- Anxiety
- Anger and frustration
- Acute stress disorder—distress, memories, avoidance, and feeling numb in the months after trauma
- Depression
- Post-traumatic symptoms and/or disorder
Diagnosis
A medical team will assess symptoms and health history. A physical exam will be done. It may include an exam of the chest, belly, pelvic area, arms or legs. Tests may be done on the brain and nervous system.
Other tests may include:
- A mental health exam
- Blood tests
Imaging tests may be used to check the injured area. These may include:
- Chest x-ray
- Abdominal ultrasound
- CT scan
- Spine x-ray
- Angiography
Treatment
Treatment depends on the cause, severity, or location of the injury. Options may be:
Immobilize and Stabilize the Injury
Severe injuries need to be stabilized. This is to help reduce further damage. It may require:
- Splinting or bracing
- IV fluids
- Being monitored in the hospital
- A breathing tube for a blocked airway
- Mechanical ventilation to take over breathing
Surgery
Some injuries may require surgery. This may be done right away or later. It depends on how severe the damage is. Examples are:
- Surgery to control bleeding
- Neurosurgery—to repair the spinal cord, brain, and/or nerves
- Creating a tracheostomy—to help with breathing
- Repairing or connecting broken bones with wires, screws, or plates
- Reconstructive or plastic surgery
- Removing dead tissue and skin grafting—for severe burns
- Creating a urostomy or colostomy to restore bladder and bowel function—this may be temporary or permanent
Recovery and Rehabilitation
For some, recovery may be short (days or weeks). For others, it may take a long time (months or years).
In general, recovery and rehabilitation may include:
- Physical therapy—to help with movement
- Occupational therapy—to assist with everyday tasks and self-care
- Respiratory therapy—to assist with breathing
- Speech and swallowing therapy
- Psychological therapy—to improve mood and reduce depression
Prevention
There are many ways to reduce the risk of trauma. Learn about and practice:
- Car safety and responsible driving
- How to keep the home safe from fires, falls, and other accidents
- Boat and water safety
- Safety measures for recreation, sports, and using machinery
- Child safety
- Violence prevention
- Responsible use of alcohol and certain medicines
References
- Approach to the trauma patient. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/injuries-poisoning/approach-to-the-trauma-patient/approach-to-the-trauma-patient.
- Khellaf, A., Khan, D.Z., et al. Recent advances in traumatic brain injury. Journal of Neurology, 2019; 266 (11): 2878-2889.
- Major trauma—emergency management. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/major-trauma-emergency-management.
- Management of chronic spinal cord injury. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/management-of-chronic-spinal-cord-injury.
- Traumatic spinal cord injury. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/traumatic-spinal-cord-injury.
- Trauma fact sheet. National Institute of General Medical Sciences website. Available at: https://www.nigms.nih.gov/Education/pages/Factsheet%5FTrauma.aspx.