Spinal cord
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Retrospective Nationwide Inpatient Sample (NIS) study. ⋯ Our analysis demonstrates that SCI patients are more at risk for ARDS/ALI, which carries a significantly higher risk of mortality.
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In addition to spinal fracture and/or dislocation, acute traumatic spinal cord injury (SCI) includes neural tissue and vascular damage at the site of contusion. Vascular damage results in spinal cord ischemia, which is a key factor that contributes to secondary pathogenesis. There is a need to identify spinal cord ischemia secondary to anterior spinal artery (ASA) rupture in acute cervical SCI. ⋯ CTA provides the most detailed, highest resolution imaging of ASA in acute cervical SCI. ASA rupture is not commonly seen in acute blunt cervical SCI.
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Retrospective review. ⋯ The discrepancies between LT and PP could relate to the greater complexity of the PP test or a difference in the extent of injury to the posterior columns (LT) and spinothalamic (PP) tracts. Further interpretation would benefit from additional electrophysiological sensory tests.
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An observational study. ⋯ Patients with more symptomatic AD tended to have significant DBP elevation and more rapid SBP/DBP increments, and this was negatively correlated with age. Aging decreases AD symptoms and the magnitude of DBP elevation, possibly through the mechanism of decreased baroreceptor sensitivity. BP monitoring during UD and other invasive procedures is strongly recommended, especially for elderly SCI patients.
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Systemic hypothermia remains a promising neuroprotective strategy. There has been recent interest in its use in patients with spinal cord injury (SCI). In this article, we describe our extended single center experience using intravascular hypothermia for the treatment of cervical SCI. ⋯ The results are promising in terms of safety and improvement in neurological outcome. To date, the study represents the largest study cohort of cervical SCI patients treated by modest hypothermia. A multi-center, randomized study is needed to determine if systemic hypothermia should be a part of SCI patients' treatment for whom few options exist.