Spinal Cord Injury Diagnosis and Imaging

17 Questions

What is critical when dealing with drainable lesions?

Time to definitive care

What can healthcare practitioners be responsible for if they don't manage patients properly?

Secondary brain injury

What happens to patient outcomes if rehabilitation is inaccessible?

They become worse

What can prevent worse outcomes for patients with head and spinal cord injuries?

Proper management and prevention of injuries

What makes a significant difference in patient outcomes according to the text?

The basics

What is the primary goal of shunting in vascular surgery?

To allow perfusion and maintain blood flow

What is a common complication of vascular injuries?

Compartment syndrome

When is damage control vascular surgery typically performed?

In multiple injuries with a patient in gross physiological extremis

What is the purpose of packing in vascular surgery?

To contain and tamponade the bleeding

What is a sign of compartment syndrome?

Pain that is out of proportion to the injury

What is the goal of ligation in vascular surgery?

To tie off the bleeding vessel

Why is it necessary to stabilize a patient before undergoing an MRI for spinal cord injury diagnosis?

Because ventilation is very difficult in the MRI machine

What is the prognosis for patients with spinal cord injuries who present with incomplete lesions?

They have a better prognosis, especially with Brown-Sequard lesions

What is a common complication that can lead to re-admission in patients with spinal cord injuries?

All of the above

What is the condition characterized by high fevers, hypertension, tachycardia, and bradycardia in patients with spinal cord injuries?

Autonomic dysreflexia

Why is it important to prevent high cervical injuries or anterior cord syndrome in patients with spinal cord injuries?

Because they do worse than patients with lower lesions

What is the reason why patients who cannot come off the ventilator may develop pneumonia and pressure sores?

Because home ventilators are not available in the public sector

Study Notes

Pseudoaneurysm is a complication that occurs when an artery ruptures, and a stent is deployed to repair the vessel.
Damage Control Vascular Surgery is a rare procedure used in cases of multiple injuries and severe physiological instability, typically in patients who are shocked, coagulopathic, hypothermic, and have lactic acidosis.
Shunting involves using tubes to allow blood flow and perfusion in vascular structures, and is used to manage vascular injuries.
Ligation involves tying off bleeding vessels, while packing involves using swabs to contain and tamponade bleeding.
Complications of vascular injuries include compartment syndrome, which is characterized by increased pressure within the myofascial compartment, leading to pain, paraesthesia, numbness, and pallor.
Compartment syndrome can progress to paresis, paralysis, pulselessness, and poikilothermia if left untreated.
Reperfusing the compartment is critical to prevent long-term damage.
Time to definitive care is critical in managing vascular injuries, and delays can lead to worse outcomes.
Healthcare practitioners have a responsibility to prevent secondary brain injury and manage patients properly to minimize morbidity.
Access to rehabilitation is limited in South Africa, particularly for patients with head and spinal cord injuries, making prevention and proper management crucial.
Basics such as fluid management and preventing vasodilatation can make a significant difference in patient outcomes.
Definitive diagnosis of spinal cord injury requires an MRI, which can only be done when the patient is stable.
Patients with spinal cord injuries require careful management, including mechanical ventilation, to prevent complications such as pneumonia and pressure sores.
Patients with incomplete lesions, particularly Brown-Sequard lesions, have a better prognosis, while those with high cervical injuries or anterior cord syndrome have a worse prognosis.
Autonomic dysreflexia is a condition that can occur in patients with spinal cord injuries, characterized by periods of high fever, hypertension, tachycardia, and bradycardia, and is difficult to treat.

This quiz covers the diagnosis and imaging of spinal cord injuries, including the use of MRI and its limitations. It also discusses the importance of patient stability before undergoing an MRI scan.

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