Book contents
- Frontmatter
- Contents
- Contributors
- Foreword
- Introduction
- SECTION I PRINCIPLES OF NEUROCRITICAL CARE
- SECTION II NEUROMONITORING
- SECTION III MANAGEMENT OF SPECIFIC DISORDERS IN THE NEUROCRITICAL CARE UNIT
- 10 Ischemic Stroke
- 11 Intracerebral Hemorrhage
- 12 Cerebral Venous Thrombosis
- 13 Subarachnoid Hemorrhage
- 14 Status Epilepticus
- 15 Nerve and Muscle Disorders
- 16 Head Trauma
- 17 Encephalopathy
- 18 Coma and Brain Death
- 19 Neuroterrorism and Drug Overdose
- 20 Central Nervous System Infections
- 21 Spinal Cord Injury
- 22 Postoperative Management in the Neurosurgical Critical Care Unit
- 23 Ethical and Legal Considerations in Neuroscience Critical Care
- SECTION IV MANAGEMENT OF MEDICAL DISORDERS IN THE NEUROCRITICAL CARE UNIT
- Index
- Plate section
21 - Spinal Cord Injury
from SECTION III - MANAGEMENT OF SPECIFIC DISORDERS IN THE NEUROCRITICAL CARE UNIT
Published online by Cambridge University Press: 27 April 2010
- Frontmatter
- Contents
- Contributors
- Foreword
- Introduction
- SECTION I PRINCIPLES OF NEUROCRITICAL CARE
- SECTION II NEUROMONITORING
- SECTION III MANAGEMENT OF SPECIFIC DISORDERS IN THE NEUROCRITICAL CARE UNIT
- 10 Ischemic Stroke
- 11 Intracerebral Hemorrhage
- 12 Cerebral Venous Thrombosis
- 13 Subarachnoid Hemorrhage
- 14 Status Epilepticus
- 15 Nerve and Muscle Disorders
- 16 Head Trauma
- 17 Encephalopathy
- 18 Coma and Brain Death
- 19 Neuroterrorism and Drug Overdose
- 20 Central Nervous System Infections
- 21 Spinal Cord Injury
- 22 Postoperative Management in the Neurosurgical Critical Care Unit
- 23 Ethical and Legal Considerations in Neuroscience Critical Care
- SECTION IV MANAGEMENT OF MEDICAL DISORDERS IN THE NEUROCRITICAL CARE UNIT
- Index
- Plate section
Summary
EPIDEMIOLOGY
Spinal cord injury (SCI) may be defined as disruption of the normal anatomy of the spinal cord with consequential neurologicdeficit. On average, 10,000 new cases of SCI occur in the United States annually; with an estimated 225,000–288,000 individuals currently living with paralysis. The two most frequently injured regions are cervical C4–6 (39.4%) and thoracolumbar T12-L1 (11.6%). Correspondingly the most common levels of neurologic injury are:
▪ Cervical (51%)
▪ Th oracic (34.3%)
▪ Lumbosacral (10.7%)
In descending order of frequency, the majority of spine and spinal cord trauma are caused by:
▪ Motor vehicle crashes (MVCs)
▪ Falls
▪ Acts of violence (most commonly gunshot wounds)
▪ Recreational sporting activities (e.g., diving, contact sports, snowmobiling, etc.)
Since 2000, sports-related and violent spinal cord injuries have both decreased; however, those due to falls have increased – a trend that may reflect the continuing rise in the median age of the general population. Indeed, SCI in the elderly population (>60 years of age) has doubled since the 1980s and is most commonly caused by falls. The median age of persons with SCI is 37.6 years of age, an increase from the 1980s and early 1990s, also likely due to the aging population and proportion of injuries in the elderly. SCI in younger individuals continues to be caused primarily by motor vehicle accidents, violence, and sport related injuries.
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- Information
- Neurocritical Care , pp. 283 - 293Publisher: Cambridge University PressPrint publication year: 2009