Spinal cord
-
Comparative Study
Effect of intrathecal nimodipine on spinal cord blood flow and evoked potentials in the normal or injured cord.
A method was developed for administering intrathecal pharmacotherapy in a rat model of spinal cord injury. The effects of intrathecal administration of nimodipine on spinal cord blood flow (SCBF) and evoked potentials (EPs) were measured in the normal and injured spinal cord. It had previously been shown that systemic nimodipine caused severe hypotension after spinal cord injury. ⋯ In all three groups of uninjured rats, the amplitude of the cerebellar EP was decreased 30 min after infusion. After spinal cord injury, there were significant decreases in MABP, SCBF and EP amplitude in both placebo and treatment groups, but there was no therapeutic benefit from nimodipine. Thus, intrathecal infusion of nimodipine did not prevent the hypotension encountered with systemic administration and exerted no beneficial effect on SCBF or EPs after acute spinal cord injury.
-
Atlantoaxial subluxation in Down syndrome rarely becomes neurologically symptomatic in very young children. The authors present a 32-month-old girl with Down syndrome, who had tetraporesis due to an atlantoaxial subluxation. ⋯ After 1-year follow-up, her motor functions were normal, and the dynamic roentgenogram of the cervical spines showed good stability. The authors recommend posterior fusion and postoperative halo immobilization for the treatment of the symptomatic atlantoaxial subluxation in young Down syndrome patients, even in a 32-month-old child.
-
Amongst complications arising from spinal cord injury (SCI), chronic gastrointestinal (G-I) problems and bowel dysfunction have not received as much research attention as many other medical and rehabilitation problems, even although their incidence is not negligible. We therefore investigated chronic G-I problems and bowel dysfunction in SCI patients where the degree of these was such that activities of daily living (ADL) were significantly affected and/or long-term medical management was required. Detailed semi-structured individual interviews were conducted with 72 traumatic SCI patients. ⋯ With regard to frequency, time, and method of defection, bowel care habits varied considerably amongst individuals, and in relation to the extent to which practical results matched the level of expectation generated by physicians' recommended care program. Individual satisfaction was also very subjective. We therefore suggest that during the early stage of rehabilitation, an appropriate bowel program should be properly designed and adequate training provided.