Spinal Cord Injury, Detailed - Everything You Need To Know - Dr. Nabil Ebraheim
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- Опубликовано: 3 июн 2024
- Dr. Ebraheim’s educational animated video describes spinal cord injury in detail.
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Spinal Cord Injury Detailed
A patient was involved in a motor vehicle accident, and the patient is unable to move all four extremities. We will start the examination with applying the ABC’s for trauma patients: Airway, Breathing and ventilation, Circulation and hemorrhage control, Disability evaluation, Exposure/Environmental control. Spinal cord injury above C5 will most likely require intubation, especially if the patient has complete quadriplegic. Spinal cord injury patients are at risk for hemodynamic shock and neurogenic shock. You are going to finish the initial survey. Next, you are going to resuscitate the patient. The patient is then examined and a thorough neurological exam should be done. To check if the patient is in spinal shock, check the bulbocavernosus reflex (S3). Spinal shock means that the patient does not have the bulbocavernosus reflex. The anal sphincter will not contract when the reflex is absent. In spinal shock, the peripheral neurons are temporarily unresponsive to the brain stimuli. The injury is similar to a hurricane that wipes out everything and shocks everything. There is no motor or sensory below the level of the lesion. There is flaccid paralysis and no bulbocavernosus reflex. The bulbocavernosus reflex returns in about 48 hours. The local activity and functions start to return. When the bulbocavernosus reflex comes back, this signals the end of the spinal shock. Assess how much damage was done to the structures. We are going to try and establish the connection (similar to a functional internet). The brain controls everything. The brain sends a signal, and we are going to see if that signal is present in the destroyed areas. Complete spinal cord injury is the loss of motor and sensation below the level of the lesion following a spinal cord injury. Incomplete means spinal cord injury with some neurological function distal to the injury. It can be motor, sensory, or sacral sparing, which can be voluntary rectal tone, anal contraction, or perianal sensation. If there is sacral sparing, this means that the injury is incomplete. If there is no sacral sparing, then the injury is complete. Grade 1/5 means a flicker of contraction alone. Grade 2/5 will have some movement if gravity is eliminated. Grade 3/5 means muscle contraction against gravity. Grade 4/5 means muscle contraction against gravity and some resistance. Grade 5/5 means normal. Next, determine if the injury is complete or incomplete by focusing on sacral sparing. You want to find sacral sparing because that will mean that the patient’s injury is incomplete, and this will have a better prognosis. Central cord syndrome is the most common type. It is caused by hyperextension injuries, and it is seen in older patients. Anterior cord syndrome has a poor prognosis, and it is usually vascular. Brown-Sequard syndrome is a hemisection of the spinal cord, and it has a good prognosis. There will be loss of ipsilateral motor function, and contralateral loss of pain and temperature sensation. Posterior cord syndrome is very rare and is associated with loss of proprioception, deep touch, and vibration. The sensory level is used when there is no motor level to test, such as in the thoracic spine. Neurogenic shock is hypotension and bradycardia following acute spinal cord injury, due to disruption of the autonomic pathway and loss of the sympathetic tone to the heart. There will be wide spread vasodilation with a decrease in the systemic vascular resistance due to injury to the descending sympathetic system. Monitoring with swan ganz may be helpful for careful fluid management. Swan ganz will really guide the appropriate fluid management and resuscitation. You may give vasopressors to the patient to treat the hypotension. Hypotension and tachycardia is hypovolemic shock. Hypotension and bradycardia is neurogenic shock. Autonomic dysreflexia occurs in complete spinal cord injury due to sympathetic overcharge (increased activity). Uncontrollable sympathetic output associated with certain triggers. Usually unchecked visceral stimulation such as fecal impaction or obstruction of the Foley catheter. It occurs in patients with spinal cord injuries above T6. It can be fatal. Patients will get headaches, agitation, almost malignant hypertension, sudden very high blood pressure, and profuse sweating. Check the patient for fecal impaction or unkink the Foley catheter. You may want to give the patient antihypertensive medications.
My mom had a T10-T11 incomplete injury from spinal stenosis. She lived with the paralysis for about fifteen years. She survived a miserable life for all that time. The worst of it was that she lived in horrible neurogenic pain everyday for the rest of her life. I miss u mom
God rest your mum 🤲🏻
@@PsyOps404 Thank you for your kind words
@@Jegganathsurya9619 Thank you so much
really very sad😢😢
I'm so sorry your mom suffered with pain everyday. She was blessed to have a child like you. I'm sorry for your loss.
thanks for the great comparison you make which make concepts more easy to remember
This is the bsst. Thank you Dr. Ebraheim!
Very good and easy to understand. Thank you so much.
Many thanks Prof. Great as always.
Thank you dr. Nabil very informative and brief 👌💕
Brilliant explanation! Many thanks.
الله يجزاك خير 🏅
وكتب لك اجر العلم النافع
اللهم صل وسلم على نبينا محمد وعلى آله وصحبه.
Great profeesor, thank you so much
Very informative. You are a great teacher par excellent
Very helpful. Thanks so much...
Very helpful .thank you ,kind sir .
Nice video... Love from India ❤️🇮🇳❤️
thank you so much sir!
Its really helpfull video sir thanks
SO HELPFUL
Thank you!
جميل جدا يا بروف
انتفع بها كثيرا
ربنا يبارك لك
Thank you Pr.
I have a related question, if you don't mind, it's regarding my personal case, which is Sum of multiple traumatic sport injuries with an uncommon symptoms effecting the neurological system of my body (Major body chronic symptoms accordingly) .
I am at my late 30's, Optimum body-Normal scales, with no family medical history.
My Case started with a swimmers hyper extension hypothesis when i was 21 years old.
One of the audiences arround the pool did grap my sholder upward with applying a rotation.
My body was in a free style swimmer position (Max. Ex. /sprint situation using the full range with expanding the muscles as i was trying to reach the Edge or the end of the swimming Pool).
The contacting points for the Alien Force :
- middle finger and the Rest by one left hand hand.
The ear bud by the right hand(Also with rotation, Probably towards the opposite side of the arm rotation.
The Cervical parts of my spine were twisted using the full range according to being expanded throughout the worming up process and being at the end of a sprinting wave (the maximum rang of the full extended body's position.
The drafting rotated force effect were pointing to the oposit Angle of the Shoulder Cuff Rang.
Note : An older Hip injury - more than 5 years- associated (caused by a strong het to the bott (Hips are not balanced - never neen treated ).
I know it sounds a little bit up normal, which bringing me to my main actual question related to the Educational Video.
Its regarding my body sensory arias and the route nerve associated with it.
((Can a serious injury cause all of those root arias to shuffle and change the normal root nirve function?.
Sorry for taking too much space explaining my personal case, i was trying to get you as much information as i could.
Regards
Mohammad
And Thank you again for all your pleased and fruitful efforts throughout your Videos
GOD Bless you and your work. 🙏
Thanks doc !
Sir, greetings and regards from India.
Thanks
Thank you
Good, thanks
Belajar kesini karna kasusnya lora, anyw thank you prof❤️
ขอขอบคุณ
Hi,
My husband had 7 years ago with spinal cord injury but is there a treatment for this like operation of spinal cord injury
There's any way with new ways to solve T5 complete SCI , and what about stem cells and epidural stimulator?
Thank you
What is the test to female patients to check bulbocavernous relex?
Dr.bey videolarınız muhteşem cok etkileyici tşk.ederim keşke türkce veya almanca'da altyazılı olsa?? Videolarınızı face book sayfamda paylaşmak istiyorum izniniz olursa? Hatta bir kacını paylaştım cünki cok eyitici.bana paylaşım icin izininiz olursa cok sevinirim olmassada saygı duyarım.
Great sir ...you are great surgeon...
Thank you for explanation give some medecine for pain n spinal cure
Thanks
Hello doctor,my mom spinal cord got damage,but movement in leg and whole body is normal.we should go through first from chest infection and then treat spinal cord??
Super nice goods 👍👍👍👌👌👌👌👌👌
Good morning doc,from phillippines...i have problem bcoz after operation i cant walk ,can u help me how to walk again.
Can u help for a dog with spine injury plz
Is it flaccid paralysis or spastic paralysis?
Spinal cord injury treatment
this is a lesson to take care my spinal cord.. and i love pork too.
Irrelevant comment.
ABC or CAB ???
IN TRUMA IT IS STILL ABC BUT IN CASE OF CARDIAC EMERGENCIES LIKE ACUTE MI IT IS CAB
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Thank you doc. Awful.
SO HELPFUL