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1.
World Neurosurg ; 133: 240-244, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31568906

RESUMO

BACKGROUND: Spinal epidural hematoma associated with epidural metastasis is very rare. Epidural hematoma is unusual in itself, and metastatic epidural tumors do not commonly occur. CASE DESCRIPTION: A 76-year-old man with a medical history of untreated stage III rectal cancer and chronic obstructive pulmonary disease underwent emergency spine surgery for acute development of severe quadriplegia due to cervical epidural hematoma after minor indirect trauma. Hemorrhagic lesions, such as yellow ligaments, were accompanied by hematomas that adhered to the dura mater and were confirmed on pathology to be small cell carcinoma. Some nodules were detected in the right pulmonary hilar lesion and pleural lesion on computed tomography, and stage IV small cell carcinoma was diagnosed. CONCLUSIONS: To our knowledge, spinal epidural hematoma accompanied by epidural metastasis has not previously been reported. We hypothesized that tissue invasion of malignant neoplasms may cause hemorrhagic conditions. The presence of a tumor should therefore be considered in the differential diagnosis of cases of epidural hematoma.


Assuntos
Carcinoma de Células Pequenas/complicações , Hematoma Epidural Espinal/cirurgia , Doença Pulmonar Obstrutiva Crônica/complicações , Quadriplegia/cirurgia , Neoplasias Retais/complicações , Idoso , Carcinoma de Células Pequenas/diagnóstico por imagem , Hematoma Epidural Espinal/diagnóstico por imagem , Hematoma Epidural Espinal/etiologia , Humanos , Imagem por Ressonância Magnética , Masculino , Quadriplegia/diagnóstico por imagem , Quadriplegia/etiologia , Neoplasias Retais/diagnóstico por imagem , Tomografia Computadorizada por Raios X
2.
Medicine (Baltimore) ; 98(50): e18299, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31852108

RESUMO

RATIONALE: Cervical transforaminal epidural steroid injection (TFESI), can be an effective tool to improve pain associated with cervical radiculopathy. However, complications related to the procedure have been reported. PATIENT CONCERNS: A 50-year-old woman who experienced acute cervical myelopathy with quadriparesis after cervical TFESI under fluoroscopic guidance. DIAGNOSES: The initial post-procedure cervical MRI revealed acute cervical myelopathy INTERVENTIONS:: She received 1000 mg of methylprednisolone was injected intravenously daily for 3 days OUTCOMES:: Improvement in pain, with the only remaining complaints consisting of lingering mild pain in the left hand and occasional hypoesthesia LESSONS:: Cervical TFESI, despite careful fluoroscopic localization, resulted in spinal cord injury. A spinal cord injury may be treated with conservative treatments, such as medication and rehabilitation.


Assuntos
Injeções Epidurais/efeitos adversos , Metilprednisolona/efeitos adversos , Quadriplegia/etiologia , Radiculopatia/complicações , Doença Aguda , Vértebras Cervicais , Feminino , Glucocorticoides/administração & dosagem , Glucocorticoides/efeitos adversos , Humanos , Imagem por Ressonância Magnética , Metilprednisolona/administração & dosagem , Pessoa de Meia-Idade , Quadriplegia/diagnóstico , Radiculopatia/diagnóstico
3.
Medicine (Baltimore) ; 98(48): e18137, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31770249

RESUMO

RATIONALE: Recently, commercial indoor trampoline parks have been opened around the globe, and both the number of venues and the park users are increasing. Academic literatures have largely focused on home trampoline related injuries, and less is known about the injuries associated with trampoline parks due to the limited number of studies or cases reported. In this report, we present a complete spinal cord injury sustained at a commercial indoor trampoline park. PATIENT CONCERNS: A 26-year old male developed tetraplegia after plainly jumping on the trampolines and diving into one of the foam pits head first. DIAGNOSIS: C-spine CT revealed bilateral interfacetal dislocation on C6-7, and his C-spine MRI showed anterior translational injury at C6-7 with severe cord encroachment and complete discoligamentous complex disruption. He was diagnosed with complete spinal cord injury. INTERVENTIONS: The patient underwent 30 minutes each of physical therapy and occupational therapy twice a day for a total of 25 days of in-patient rehabilitation. Interventions included tilt table, passive range of motion exercises, functional electrical stimulation, sitting balance training, upper extremity strengthening exercise, and hand manipulation exercises. OUTCOME: Despite intensive rehabilitation and the patient's good spirit, there was no functional change in all physical examinations between evaluations at initial and at discharge. LESSONS: In conclusion, we aim to alert the risks associated with improper use of trampolines, promote safer entertainment environment, and aid in developing mandatory safety measures. We hope to alert the risks associated with improper use of trampolines, promote safer entertainment environment, and aid in developing mandatory safety measures.


Assuntos
Traumatismos em Atletas/complicações , Segurança de Equipamentos/normas , Quadriplegia/etiologia , Traumatismos da Medula Espinal/etiologia , Adulto , Traumatismos em Atletas/prevenção & controle , Traumatismos em Atletas/reabilitação , Humanos , Masculino , Parques Recreativos , Quadriplegia/prevenção & controle , Quadriplegia/reabilitação , Traumatismos da Medula Espinal/prevenção & controle , Traumatismos da Medula Espinal/reabilitação
4.
Medicine (Baltimore) ; 98(43): e17456, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31651848

RESUMO

INTRODUCTION: Calcification of ligamentum flavum (CLF) is an important cause of spinal stenosis and spinal cord compression. CLF does not usually induce immediate quadriparesis. Here we describe a rare case of immediate quadriparesis due to a large calcified mass containing liquids in the ligamentum flavum, which was easily confused with gout crystals. PATIENT CONCERNS: A 74-year-old Asian male felt progressive bilateral arm and leg weakness. On the fourth day, acute quadriparesis occurred. DIAGNOSIS: Coronal and sagittal computerized tomography (CT) and magnetic resonance imaging (MRI) showed a large circular mass in the left posterior part of the cervical 3/4 spinal canal, protruding into the canal, and occupying one-half of the spinal canal. INTERVENTIONS: Emergency laminectomy was performed at C3/4 level. The huge cyst was excised and 1 ml of white viscous liquid flowed out. OUTCOMES: After operation, CT and MRI showed a full laminectomy of C3/4 and complete decompression of the cervical spinal cord. Hematoxylin-eosin (HE) staining showed that large amounts of calcium was deposited around cystic tissues. Five-year follow-up after laminectomy showed good recovery. CONCLUSION: This case of immediate quadriparesis, caused by a large calcified mass containing fluid, is very rare. It should be at the earliest stage of calcification. Laminectomy is an effective treatment. This calcification was deceptive and was easily confused with gout crystals. It can help to understand the exact pathophysiology of CLF.


Assuntos
Calcinose/complicações , Vértebras Cervicais/patologia , Ligamento Amarelo/patologia , Quadriplegia/diagnóstico , Doenças da Coluna Vertebral/complicações , Idoso , Calcinose/patologia , Calcinose/cirurgia , Diagnóstico Diferencial , Humanos , Laminectomia/métodos , Masculino , Quadriplegia/etiologia , Quadriplegia/cirurgia , Doenças da Coluna Vertebral/patologia , Doenças da Coluna Vertebral/cirurgia , Resultado do Tratamento
5.
Rinsho Shinkeigaku ; 59(10): 641-645, 2019 Oct 26.
Artigo em Japonês | MEDLINE | ID: mdl-31564701

RESUMO

A 76-year-old Japanese female who was treated with long-term use of prednisolone at 10 mg/day for interstitial pneumonia developed acute right-dominant lower limb paralysis and then upper limb paralysis with herpes zoster eruptions on the right C7-Th1 dermatomes. On admission, right predominant quadriplegia was observed with sensory symptoms; Hughes functional grade was level 4; the hand grip power was right, 0, and left, 7 kg, the deep tendon reflexes were abolished throughout without pathologic reflexes. Twenty days after the onset of the symptoms, the cerebrospinal fluid (CSF) revealed mild increases of lymphocytes (13 cells/µl) and protein content (73 mg/dl). Varicella-zoster virus (VZV) PCR was negative in the CSF, but an enzyme immunoassay for VZV was positive in her serum and CSF, and the high titers were prolonged. Peripheral nerve conduction and F wave studies suggested right-dominant demyelinating polyradiculoneuropathy. A T1-weighted MR contrast image exhibited right-dominant high-intensity lesions on the C7-Th1 spinal roots and similar lesions on the L4-5 spinal roots. We compared with several similar cases from the literature and proposed that VZV itself involves the pathogenesis of the polyradiculoneuritis in immunocompromised hosts.


Assuntos
Herpes Zoster/complicações , Polirradiculoneuropatia/complicações , Polirradiculoneuropatia/virologia , Infecção pelo Vírus da Varicela-Zoster , Aciclovir/administração & dosagem , Aciclovir/efeitos adversos , Idoso , Anticorpos Antivirais/sangue , Anticorpos Antivirais/líquido cefalorraquidiano , Antivirais/administração & dosagem , Antivirais/efeitos adversos , Biomarcadores/sangue , Biomarcadores/líquido cefalorraquidiano , Imagem de Difusão por Ressonância Magnética , Feminino , Síndrome de Guillain-Barré , Herpes Zoster/tratamento farmacológico , Herpesvirus Humano 3/imunologia , Humanos , Hospedeiro Imunocomprometido , Imunoglobulinas Intravenosas/administração & dosagem , Oxidiazóis/administração & dosagem , Polirradiculoneuropatia/diagnóstico , Polirradiculoneuropatia/tratamento farmacológico , Quadriplegia/etiologia
6.
World Neurosurg ; 132: 12-13, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31450000

RESUMO

BACKGROUND: Only a few cases of spinal cord compression after cervical laminectomy have been reported. CASE DESCRIPTION: We report a case of tetraparesis after executing a C3-C6 anterior and posterior decompression and fusion. Cervical magnetic resonance imaging demonstrated a spinal cord compression due to the impingement of the paraspinal muscles through the laminectomy. The patient experienced a spontaneous neurological recovery and the follow-up cervical magnetic resonance imaging showed resolution of the spinal cord compression. CONCLUSIONS: This rare complication should be considered among the others after executing a cervical laminectomy.


Assuntos
Vértebras Cervicais/cirurgia , Descompressão Cirúrgica , Laminectomia , Músculos Paraespinais/diagnóstico por imagem , Complicações Pós-Operatórias/diagnóstico por imagem , Compressão da Medula Espinal/diagnóstico por imagem , Fusão Vertebral , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Quadriplegia/etiologia , Compressão da Medula Espinal/complicações , Compressão da Medula Espinal/cirurgia
7.
J Clin Neurosci ; 70: 254-257, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31439490

RESUMO

Hypokalemic periodic paralysis secondary to distal renal tubular acidosis presenting with prominent bulbar symptoms is extremely rare. The exact pathophysiology by which hypokalemia causes weakness is yet to be elucidated though muscle and nerve membrane hyperpolarization have been hypothesized. The pathophysiology of bulbar involvement in this condition is even more unclear. We report a case presenting as acute flaccid quadriplegia with prominent bulbar symptoms that reversed once potassium levels returned to normal. Serial nerve conduction studies were performed at various potassium levels revealing electrophysiologic abnormalities that corrected with potassium repletion. A systematic review of the literature was also conducted focusing on bulbar symptoms and electrophysiologic findings in hypokalemic periodic paralysis. Nerve conduction abnormalities in this condition are seldom documented, but reports have shown reduced amplitudes of compound motor action potentials and abnormal F-waves during acute attacks of hypokalemic paralysis.


Assuntos
Paralisia Bulbar Progressiva/etiologia , Paralisia Bulbar Progressiva/fisiopatologia , Paralisia Periódica Hipopotassêmica/complicações , Paralisia Periódica Hipopotassêmica/fisiopatologia , Acidose Tubular Renal/complicações , Feminino , Humanos , Masculino , Quadriplegia/etiologia
11.
BMJ Case Rep ; 12(6)2019 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-31189542

RESUMO

Spinal cord injury (SCI) is associated with a range of secondary health issues. Altered neurological function can complicate diagnosis, which may have serious consequences. Here we present the case of a tetraplegic person presenting with confusion and bradycardia. Initial testing revealed severe hyponatraemia (sodium 96 mmol/L) and ST elevation associated with labile blood pressure. Delayed further investigation identified sigmoid volvulus-endoscopic decompression led to resolution of haemodynamic lability and a diagnosis of autonomic dysreflexia. Low mood and poor documentation in the community were found to contribute to poor compliance with an established bowel management plan. Inpatient care involved electrolyte correction and establishment of regular bowel motions. The patient was discharged at baseline neurology with psychological support. This case highlights poor awareness of the secondary health issues affecting those with SCI and the complex relationship between mental and physical health.


Assuntos
Disreflexia Autonômica/fisiopatologia , Hiponatremia/fisiopatologia , Quadriplegia/fisiopatologia , Traumatismos da Medula Espinal/fisiopatologia , Adulto , Disreflexia Autonômica/etiologia , Humanos , Hiponatremia/etiologia , Quadriplegia/etiologia , Traumatismos da Medula Espinal/complicações
13.
World Neurosurg ; 128: 611-615.e1, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31078807

RESUMO

BACKGROUND: Tetraplegia caused by cervical spinal cord injury is devastating for patients and represents a significant public health problem in both developed and developing countries. Improved functional outcomes after nerve transfers are increasingly reported in the literature, but thus far, no options exist for injuries above the C5 level. CASE DESCRIPTION: We report the cases of 2 patients with C4 spinal cord injury, American Spinal Injury Association A, who underwent successful bilateral spinal accessory nerve transfers, on 1 side to the triceps nerve with long intervening sural graft and on the other side direct transfer to the motor fascicles of the middle trunk. Patients improved from Medical Research Council 0 to 4 on the side of the nerve graft and 0 to 2 or 3 on the side of the direct transfer. Both patients also underwent transfer of the greater auricular nerve to sensory fascicles of the middle trunk, and they experienced sensory recovery in the C6 distribution. Notably, both patients were far removed from the traditional window of nerve transfer surgery at 4 years and almost 11 years out from injury. CONCLUSIONS: We describe 2 successful cases of the first and to date only option for motor and sensory reinnervation in high cervical spinal cord injuries. These procedures provide a robust nerve transfer option capable of improving quality of life in tetraplegic patients. There may be a significant undertreated population of patients with cervical spinal cord injury patients in the United States who were previously considered outside the window for benefiting from nerve transfers but who would benefit from these techniques.


Assuntos
Nervo Acessório/transplante , Plexo Braquial/cirurgia , Transferência de Nervo/métodos , Quadriplegia/cirurgia , Traumatismos da Medula Espinal/cirurgia , Nervo Sural/transplante , Adolescente , Adulto , Plexo Cervical/cirurgia , Vértebras Cervicais , Humanos , Masculino , Quadriplegia/etiologia , Traumatismos da Medula Espinal/complicações
15.
Neurology ; 92(24): e2793-e2802, 2019 06 11.
Artigo em Inglês | MEDLINE | ID: mdl-31092621

RESUMO

OBJECTIVE: To assess whether preserved dorsal and ventral midsagittal tissue bridges after traumatic cervical spinal cord injury (SCI) encode tract-specific electrophysiologic properties and are predictive of appropriate recovery. METHODS: In this longitudinal study, we retrospectively assessed MRI scans at 1 month after SCI that provided data on width and location (dorsal vs ventral) of midsagittal tissue bridges in 28 tetraplegic patients. Regression analysis assessed associations between midsagittal tissue bridges and motor- and sensory-specific electrophysiologic recordings and appropriate outcome measures at 12 months after SCI. RESULTS: Greater width of dorsal midsagittal tissue bridges at 1 month after SCI identified patients who were classified as being sensory incomplete at 12 months after SCI (p = 0.025), had shorter sensory evoked potential (SEP) latencies (r = -0.57, p = 0.016), and had greater SEP amplitudes (r = 0.61, p = 0.001). Greater width of dorsal tissue bridges predicted better light-touch score at 12 months (r = 0.40, p = 0.045) independently of baseline clinical score and ventral tissue bridges. Greater width of ventral midsagittal tissue bridges at 1 month identified patients who were classified as being motor incomplete at 12 months (p = 0.002), revealed shorter motor evoked potential (MEP) latencies (r = -0.54, p = 0.044), and had greater ratios of MEP amplitude to compound muscle action potential amplitude (r = 0.56, p = 0.005). Greater width of ventral tissue bridges predicted better lower extremity motor scores at 12 months (r = 0.41, p = 0.035) independently of baseline clinical score and dorsal tissue bridges. CONCLUSION: Midsagittal tissue bridges, detectable early after SCI, underwrite tract-specific electrophysiologic communication and are predictors of appropriate sensorimotor recovery. Neuroimaging biomarkers of midsagittal tissue bridges may be integrated into the diagnostic workup, prediction of recovery, and patients' stratification in clinical trials.


Assuntos
Medula Cervical/diagnóstico por imagem , Potencial Evocado Motor/fisiologia , Potenciais Somatossensoriais Evocados/fisiologia , Lesões do Pescoço/diagnóstico por imagem , Quadriplegia/fisiopatologia , Recuperação de Função Fisiológica , Traumatismos da Medula Espinal/diagnóstico por imagem , Adulto , Idoso , Medula Cervical/lesões , Vértebras Cervicais , Feminino , Humanos , Estudos Longitudinais , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Lesões do Pescoço/complicações , Lesões do Pescoço/fisiopatologia , Prognóstico , Quadriplegia/etiologia , Medula Espinal/diagnóstico por imagem , Traumatismos da Medula Espinal/complicações , Traumatismos da Medula Espinal/fisiopatologia , Adulto Jovem
16.
Phys Med Rehabil Clin N Am ; 30(2): 367-384, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30954153

RESUMO

Tetraplegia resulting from cervical injury is the most frequent neurologic category after spinal cord injury and causes substantial disability. The residual strength of partially paralyzed muscles is an important determinant of independence and function in tetraplegia. Small improvements in upper extremity function can make a clinically significant difference in daily activities. Major advances in rehabilitation technologies over the past 2 decades have allowed testing of robotic devices in rehabilitation of motor impairments. This literature assessment provides an overview of robotic-assisted training research for improving arm and hand functions after cervical spinal cord injury.


Assuntos
Medula Cervical/lesões , Reabilitação Neurológica , Robótica , Traumatismos da Medula Espinal/reabilitação , Terapia Assistida por Computador , Humanos , Reabilitação Neurológica/instrumentação , Quadriplegia/etiologia , Quadriplegia/fisiopatologia , Quadriplegia/reabilitação , Traumatismos da Medula Espinal/fisiopatologia , Terapia Assistida por Computador/instrumentação , Extremidade Superior/fisiopatologia
17.
Nutr Hosp ; 36(3): 517-525, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-30958686

RESUMO

Introduction: Introduction: children with cerebral palsy (CP) have multiple risk factors for low bone mineral density or osteoporosis. Objective: to explore the association between bone mineral density (BMD) and biochemical and hormonal indicators of bone metabolism in children with quadriplegic cerebral palsy (CP). Methods: a cross-sectional analytical study included 59 participants from six to 18 years of age with quadriplegic CP. Serum concentrations of calcium, phosphorus, 25OHD metabolite, parathyroid hormone (PTH), alkaline phosphatase, and thyroid hormones were determined using standardized methods. The BMD measurement was obtained from the lumbar spine expressed in g/cm2 and Z-score. Unpaired Student's t-test, Chi-square test, odds ratio and Pearson's correlation were performed. Results: participants with CP and malnutrition had lower serum concentrations of calcium, phosphorus and alkaline phosphatase. Those who had low BMD showed lower serum concentrations of calcium, phosphorus and alkaline phosphatase. Most participants with low and normal BMD had vitamin D deficiency (27.1% and 10%) and insufficiency (35.4% and 30%), respectively. There was a significant correlation between BMD and serum concentrations of calcium, phosphorus, alkaline phosphatase, vitamin D and thyroid-stimulating hormone (TSH). There were no differences in the biochemical and hormonal indicators by level of gross motor function, use of anticonvulsants and oral versus enteral feeding method. Conclusion: malnutrition and alteration of vitamin D nutritional status were associated with low BMD and alterations of biochemical indicators of bone metabolism in pediatric patients with quadriplegic CP. The relationship between BMD and biochemical indicators of bone metabolism in children with quadriplegic CP was also demonstrated.


Assuntos
Densidade Óssea , Paralisia Cerebral/metabolismo , Hormônios/metabolismo , Quadriplegia/metabolismo , Adolescente , Cálcio na Dieta , Paralisia Cerebral/complicações , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Desnutrição/metabolismo , Estado Nutricional , Quadriplegia/etiologia , Hormônios Tireóideos/sangue , Deficiência de Vitamina D/complicações
18.
Am J Clin Hypn ; 61(4): 394-408, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31017549

RESUMO

This case study reports on a 28-year-old male with spinal cord injury (SCI), quadriplegia, and chronic pain with neuropathic characteristics. The treatment had to be adapted to address the patient's needs, as he was on a respirator and paralyzed from the chin down. The intervention consisted of eight 90-minute sessions. The first four sessions were based on a standardized hypnotic cognitive therapy protocol developed for a randomized controlled trial (RCT). The sessions included training in cognitive restructuring skills and a hypnosis session with suggestions that was audiorecorded. Instructions to practice at home, both with the recording and by using self-hypnosis, were provided as well. Most of the outcome domains assessed (i.e., pain intensity, pain interference, sleep quality) showed clinically meaningful improvements that were maintained (or increased) at one-year follow-up. The patient reported that he was still using self-hypnosis at one-year follow-up. His subjective impression of change was positive and he did not report any negative side effects. Results show that the hypnotic cognitive therapy protocol used is a promising intervention that can benefit individuals with SCI presenting with complex symptomatology. Such therapy helps patients by teaching them effective coping strategies that they can use on their own to manage pain and its effects. In addition, it is important to note that this therapy provided benefits to someone who had not experienced any benefits from numerous medications he had tried before treatment. Therefore, the findings support continued efforts to make this treatment more accessible to patients who could benefit from this approach.


Assuntos
Dor Crônica/terapia , Terapia Cognitivo-Comportamental/métodos , Hipnose/métodos , Quadriplegia , Traumatismos da Medula Espinal , Adulto , Dor Crônica/etiologia , Humanos , Masculino , Quadriplegia/etiologia , Traumatismos da Medula Espinal/complicações
20.
Geriatr Psychol Neuropsychiatr Vieil ; 17(2): 129-136, 2019 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-31010800

RESUMO

To compare the neurological evolution, functional improvement, and outcomes after acute hospitalization for elderly patients with newly non-traumatic (NTSCI) and traumatic (TSCI) spinal cord injury. Retrospective single-center study conducted with a cohort of patients older than 70 years old with NTSCI and TSCI, admitted between January 2004 and December 2014.in a Rehabilitation center in Nantes France. One hundred and ten patients were included (43 TSCI and 67 NTSCI). Most of the NTSCI had incomplete paraplegia (p<0.001) whereas TSCI had incomplete tetraplegia (p=0.002). Falls were the main cause of traumatic injury. NTSCI and paraplegia had a favourable neurological improvement (p=0.14 and 0.02) whereas TSCI and tetraplegia remained stable (p=0.13 and p=0.007). Therefore functional status remained stable for almost half the patients. Sixty percent of the patient get an assistance or were independent in Katz ADL Index assessment, mostly were NTSCI and paraplegic (p=0.17 and 0.40). About 44% of the patients had normal micturition at discharge, they all had incomplete lesion. Fifteen patients used intermittent catheterization, most of them were TSCI (p=0.02). Private residence was the first place of residence after discharge (47%), 17% goes in nursing home residence. NTSCI were more likely to go home at discharge (p=0.07), to have less comorbidities (p=0.08), length of stay shorter (p=0.053) and a mean age at death higher (p=0.01). Twenty-six percent of the patient deceased, mostly by respiratory problem. The etiology of the lesion and level of neurological impairment influence the neurological evolution, functional improvement and the outcomes of elderly patient with newly SCI. Rehabilitation of elderly SCI must be adapted to enhance neurological and functional recovery.


Assuntos
Traumatismos da Medula Espinal/reabilitação , Acidentes por Quedas , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Hospitalização , Humanos , Vida Independente , Masculino , Exame Neurológico , Casas de Saúde , Paraplegia/etiologia , Quadriplegia/etiologia , Recuperação de Função Fisiológica , Estudos Retrospectivos , Traumatismos da Medula Espinal/diagnóstico , Traumatismos da Medula Espinal/fisiopatologia , Resultado do Tratamento , Micção
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