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PubMed1991

Head injury and spinal cord injury: differential effects on psychosocial functioning.

Closed-head injury (CHI) and spinal cord injury (SCI) cause significant permanent alterations in life style, social-role functioning, and psychological status. While the cognitive effects of CHI are well known, there have been questions concerning the psychosocial sequelae from CHI, and whether they are unique to this disability group rather than representing general effects of a life-threatening medical emergency with permanent life-altering consequences. This issue was examined with samples of ambulatory moderate (n = 31) and severe (n = 17) CHI patients and wheelchair-dependent SCI (n = 24) patients. Results indicate that there were no significant differences between the groups on pre- and post injury demographic factors. However, while the moderate CHI and SCI groups were equivalent on many indicators of psychosocial outcome, the severe CHI group was more depressed, angry and hostile, and confused and bewildered. As well, wives of the severe CHI patients rated their husbands as more belligerent, negative, helpless, suspicious, withdrawn and retarded, and with more general psychopathology than did wives of moderate CHI or wives of SCI patients. Implications of these findings for preventative psychosocial rehabilitation are discussed.

Activities of Daily Living↗
PubMed2000

Locomotion and its recovery after spinal injury.

Recent advances indicate not only that the spinal cord has great potential for locomotor recovery after lesion but also that locomotor training can optimise this recovery through some form of 'learning'. Improvement of residual function can also be achieved through the use of various drugs and treatments such as spinal grafts. In spinal-cord-injured humans, a number of recent studies have allowed an objective quantification of the improvement of locomotion through various forms of training and stimulation.

Animals↗
PubMed2005

[Surgical repair of spinal cord injuries].

Spinal cord rupture is still incurable. Axons regenerating from the brain do not advance through the damaged cord towards peripheral motoneurons. The reasons for this "nonpermissiveness" are unclear. The author's research started in 1980 on rats and monkeys, with attempts to connect the lateral tract of the cord, upstream of the lesion, to the muscles, by means of autologous grafts. This operation was subsequently performed on fully informed volunteers with total cord rupture between T8 and T11. The first patient regained a rudimentary but effective gait. This connection of upper motoneurons with peripheral muscle nerves works even when the activating axons derive from cells dispersed among different regions of the brain cortex but that fire together, providing selective contraction of single muscles. Furthermore, this functioning occurs even though upper motor neurons use the neurotransmitter glutamate, whereas motor endplates normally have acetylcholine receptors. In fact, immunoblot analysis of ChAT VAChT, Vglu-1 GluR1 and GluR2 shows that motor endplate receptors switch from choline to glutamine.

Adult↗
PubMed1993

The development of a spinal injuries unit in Armenia.

A severe earthquake in December 1988 in Armenia, resulted in a large number of spinal cord injuries. A rehabilitation facility was urgently established in Yerevan by the Red Cross with volunteers from various countries outside the then Soviet Union. A programme of training of Armenian doctors, nurses and therapists was established, and a new purpose built spinal unit planned. The new unit was opened in August 1992 and should serve as a model for similar units throughout the Commonwealth of Independent States.

Armenia↗
PubMed1992

Radicular avulsion resulting from spinal injury: assessment of diagnostic modalities.

The diagnostic utility of imaging techniques in injuries to the intramedullary and subarachnoid portions of the brachial plexus, with possibly complete avulsion of one or more nerve roots from the spinal cord and extramedullary meningocoele was compared in 18 patients studied by unenhanced computed tomography (CT), cervical myelography, myelographic CT (MCT) and magnetic resonance imaging (MRI). Emphasis was placed on the lesions of the subarachnoid roots. CM was the only diagnostic modality to show avulsion of 18 nerve roots and their levels in 8 patients (100% = gold standard), and to verify 2 incomplete avulsions. MCT reliably revealed 8 of 18 (45%) and MRI 1 out of 18 (6%) avulsions. Myelography with MCT showed intact subarachnoid nerve roots in 10 additional patients. MRI and MCT (16 out of 16 = 100%) were superior to myelography (14/16 = 88%) for demonstrating 16 traumatic meningocoeles in 8 patients; follow-up MRI (6-24 months) showed no increase in their size. We recommend a subsequent CT to role out fracture to the spinal column; MRI should provide significant information concerning oedema or haemorrhage in the spinal cord. Myelography with segmental MCT is performed to differentiate pre- from post-ganglionic lesions, data which are essential for deciding whether exploration of the plexus or a motor substitution operation is indicated.

Adolescent↗