Spinal Cord Injury and Concomitant Traumatic Brain Injury

A controlled study of neuropsychological deficits in acute spinal cord injury patients

“…Wilmot and associates (1985) noted a prevalence rate of cognitive impair ment of 64°/c) in a study of 67 SCI patients at 'high risk' for head trauma, based on the presence of any one of four inclusionary criteria (tetraplegia associated with deceleration impact, history of documented loss of consciousness, presence of neurological indicators, or need for respiratory support), using a battery of 11 tests. Richards et al (1988) recently reported that some of the cognitive deficits that were found on a standard neuropsychological test battery shortly after onset of SCI persisted for nearly 1 years following injury while patients recovered from other deficits. In particular, certain measures of attention, vocab ulary, and memory improved over time.…”

“…Between 40% and 60% of patients with acute spinal cord injury (SCI) dem onstrate various types of cognitive deficits (Schueneman and Morris, 1982;Davidoff et al, 1985a;Wilmot et al, 1985;Morris et al, 1986;Davidoff et al, 1987;Richards et al, 1988). These disorders may include poor attention and concentration, disturbed memory and learning, impaired visuospatial percep tion, and decreased problem-solving ability, all of which present barriers to full and optimal rehabilitation after spinal cord trauma.…”

“…Factors which may contribute to the occurrence of cognitive dysfunction among patients with traumatic myelopathy include concurrent or premorbid traumatic brain injury (Silver et al, 1980-81;Schueneman and Morris, 1982;Dubo and Delaney, 1984;Wagner et al, 1984;Davidoff et al, 1985a;Wilmot et al, 1985;Davidoff et al, 1985b;Morris et al, 1986;Davidoff et al, 1987;Richards et al, 1988), chronic alcohol or substance abuse (Heinemann et al, 1988), premorbid learning disability, use of psychoactive medication, or motiva tional problems. Although some of the effects of these disorders may be transi ent (Richards et al 1988), many of the problems in understanding and mental processing may persist during or beyond the first few months following injury.…”

“…Although some of the effects of these disorders may be transi ent (Richards et al 1988), many of the problems in understanding and mental processing may persist during or beyond the first few months following injury.…”

“…Several investigators have reported the magnitude and nature of neuro psychological test abnormalities among SCI patients using a broad range of assessments of cognitive function (Wilmot et al, 1985;Davidoff et al, 1985b;Richards et al, 1988). Unfortunately, applicability of the findings from many of these studies has been hampered by at least two major methodological flaws: the administration of neuropsychological tests which are limited in scope and sensitivity, and the failure to compare the frequency and severity of cognitive impairment among SCI patients with those of concurrent control subjects.…”