Study design: Mortality review was undertaken of patients who su ered traumatic spinal cord injury (SCI) between 1955 and 1994 inclusive. Objectives: The study objective was to provide evidence of reasons for the observed reduction in long-term life expectancy for the SCI population. Setting: Patients were those who had most, if not all, of their inpatient and outpatient care at Royal North Shore Hospital, Spinal Injuries Unit, Sydney, New South Wales, Australia. Methods: Data on causes of death for 195 patients ®tting the inclusion criteria were analysed by actuarial methods using ICD9CM classi®cations. Results: The incidence of death in the spinal cord injured, from septicaemia, pneumonia and in¯uenza, diseases of the urinary uystem and suicide, are signi®cantly higher than in the general population. The ®ndings con®rm variations in potentially treatable causes of death depending on neurological impairment, attained age and duration since injury. Unlike septicaemia and pneumonia, which have shown a signi®cant reduction since 1980, the death rate for suicide alone has risen. Conclusion: This analysis identi®ed complications which a ect mortality and morbidity in patients su ering from the e ects of SCI. Spinal Cord (2000) 38, 604 ± 610
A 33 year old zoo keeper was attacked by a Sumatran tiger in captivity. Apart from severe lacerations and penetrating wounds to the head and neck, the patient sustained comminuted fractures of C1 and C2 vertebrae with resultant high laceration of the spinal cord. Major vascular injury as well as trauma to pharynx also occurred. The patient survived these injuries for 15 h.
CSF flow within the posttraumatic syringomyelia group was relatively uniform along the spinal canal, but there are differences in the timing of CSF flow compared with that in matched healthy controls. This finding supports the hypothesis that syrinx development may be associated with temporal changes in spinal CSF flow.
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