Study design: Monocentric cohort study. Objective: To investigate the acquisition of knowledge about spinal cord injury (SCI)-related complications in SCI patients. Setting: Level 1 trauma center. Methods: All patients with a traumatic or non-traumatic SCI were included in the study. Data were collected at admission, post-admission at 1 and 3 months and post-discharge at 6, 18 and 30 months. The discharge of all patients was between 3 and 6 months post-admission. Knowledge about pressure ulcers and bladder management was tested using the 'Knowledge' score. This score has a minimum and maximum of 0 and 20 points. To detect differences across the multiple time intervals, the Friedman test was used. Differences in the number of patients with poor (0-8), average (9-12) and good knowledge (13-20) between the different age classifications (age at injury) were calculated using a w 2 -test. Results: A total of 214 patients were included. At discharge subjects had increased their knowledge score to 11.2 compared with 5.4 on admission (Po0.001). After 30 months, however, the mean score decreased to 10.8 points. At the time of discharge, the number of patients who achieved poor, average or good knowledge were 48 (22.4%), 65 (30.4%) and 101 (47.2%), respectively. Subjects of B50 years old and tetraplegics had better (Po0.001) knowledge compared with subjects of B50 years old and paraplegics, respectively. Conclusion: In this study, less than 50% of SCI patients had good knowledge about bladder management and pressure ulcers after being discharged.

Study design: Monocentric Cohort Study. Objective: Development of a multi-dimensional outcome score of the rehabilitation of spinal cord injury (SCI) patients. Setting: Level 1 Trauma centre with large spinal unit. Methods: During the rehabilitation of 161 patients with SCI between 2005 and 2007 following outcome parameters were assessed at different time points: functional status, pain, emotion, energy, sleep, social isolation, knowledge and self-management attitude. The results for these parameters were statistically evaluated with regard to different grades of paralysis and analyzed for socio-demographic influence factors. Correlation and factor analysis were then applied to evaluate the dependencies of the parameters and the dimensional structure of the applied score. Results: For all factors a positive trend was found during the course of rehabilitation. Only the functional status is caused by spinal cord lesion. Age, sex and social isolation have no direct influence on the result with regard to functional status. For interactive dependencies of the parameters a threedimensional structure was found: Success in the parameters, emotion, energy or social status, is independent of success in the parameter functional status. The result of the functional status is, next to the type of spinal injury, mainly influenced by the self-management attitude. The level of knowledge gained during rehabilitation is independent of the success in the other parameters. Conclusion: By the combination of functional, psychological and cognitive parameters into a result score it is possible to determine the quality of a rehabilitation process in its multiple dimensions and for different levels and grades of palsy. By this it is possible to analyze and compare the effectiveness and efficiency of rehabilitation on a national and international level. Longitudinal comparison of the long-term effects of rehabilitation after SCI is also possible, for example, in the course of follow-up examinations. Sponsorship: Deutsche Gesetzliche Unfallversicherung (German Statutory Occupational Accident Insurance).

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Migraine as primary headache is a life-long disease which is relevant for the quality of life and is based on complex genetics. It often starts in childhood with symptoms typical for the specific age. These show different nuances compared to the migraine symptoms in adults, for example, regarding (bilateral/unilateral) localization of the acute migraine headache. Only over the course of years-during adolescence and young adulthood-do the more specific symptoms as defined by the International Classification of Headache Disorders (ICHD 3 beta) develop. In this article we focus on the clinical specifics of children and adolescents with migraine. We elaborately refer to the trigeminocervical complex (TCC) because it forms a conceptual bridge for the understanding of migraine, for psychoeducation, and for therapeutic options. We pragmatically discuss options and limits of treatments.

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