Die präklinische Diagnose der traumatischen Querschnittlähmung - eine prospektive Studie an 100 Patienten

Abstract

Possible reasons for this neurological deterioration can be secondary damages of the nervous tissue due to vascular, metabolic or biochemical mechanisms, transportation trauma or insufficient preclinical diagnostics. There is no evidence for a higher risk of secondary tissue damage for patients with cervical spinal cord injury. None of the six patients had additional injuries of the spinal cord or the vertebral column in the thoracic region, therefore transportation trauma is also unlikely. It is more likely that preclinical diagnoses were incorrect, what could have been avoided by consequent sensory and motor testing at the upper extremities.

Analysis of prehospital care and emergency room treatment of patients with acute traumatic spinal cord injury: a retrospective cohort study on the implementation of current guidelines

“…5,6 On the other hand, there are authors stating that major neurological deterioration can occur because of inadequate immobilization 7 and inappropriate handling. 8,9 Of course, many factors may contribute to increasing neurological deficits after traumatic spinal cord injury such as expanding hematoma, ongoing ischemia or hypoxia, electrolyte shifts, as well as formation of free radicals and inflammatory mediators.…”