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Traumatic Brain Injury in Patients with Spinal Cord Injury: Neuropsychological Consequences and Rehabilitation, pp. 611-622 $100.00
Authors:  Anu Tolonen
Abstract:
Traumatic brain injury (TBI) is more frequent in traumatic spinal cord injury (SCI)
patients than clinical diagnoses at hospital admission reflect. As SCI and TBI typically
result from similar, high kinetic accidents, these neurotraumas are often present
concomitantly.
In SCI, because the enormous physical injury sustained is the main focus of
attention, the basic indicators of TBI, e.g., loss of consciousness, posttraumatic amnesia
(PTA), and neurological symptoms and signs due to TBI, may go undetected and
undocumented. Moreover, patients with a Glasgow Coma Score (GCS) of 1315 may
also suffer from severe TBI, and structural damage cannot often be detected in
conventional MRI. Altered mental status, e.g. fatigue, information processing problems,
and changes in behavioural and emotional regulation, may be misinterpreted as effects of
medication, or a psychological reaction to a massive life change.
TBI is a major concern in the rehabilitation of traumatically spinal-cord-injured
patients. SCI is one of the most devastating injuries that may affect an individual.
However, from the perspectives of vocational planning, supportive interventions, and
psychosocial outcome, concomitant TBI is a central factor to be considered.
TBI produces significant impairments in cognitive, emotional, and executive
functions, which has a far reaching effect on many levels of the life of an individual.
With SCI patients suffering from concomitant TBI, there is a risk for a complicated
rehabilitation process and unfavorable outcome if TBI is not recognized and the
rehabilitation approach modified. To avoid secondary complications, necessary tools
such as enhanced diagnostics of TBI, specific treatment and rehabilitation methods,
including neuropsychological interventions and a careful follow-up, are needed. 


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Traumatic Brain Injury in Patients with Spinal Cord Injury: Neuropsychological Consequences and Rehabilitation, pp. 611-622