Concomitant Brain Injury and Spinal Cord Injury Management Strategies: A Narrative Review

Valecillos, Adriana D. Valbuena; Gater, David R.; Alvarez, Gemayaret

doi:10.3390/jpm12071108

Cited by 12 publications

(7 citation statements)

References 85 publications

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“…The incidence of constipation ranges from 32 to 41%, with an index at discharge of approximately 20%. Only one study reported a patient with a double diagnosis of SCI and ABI ( Valbuena Valecillos et al, 2022 ).…”

Section: Resultsmentioning

confidence: 99%

“…Only one study reported a patient with a double diagnosis of SCI and ABI that increased from 7 to 74% according to different criteria ( Valbuena Valecillos et al, 2022 ). The dissociation between parasympathetic and ENS can contribute to NBD in patients with SCI or traumatic brain injury (TBI; Blanke et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, a detailed evaluation of fecal consistency and volume was not conducted. From a pharmacological perspective, despite the heterogeneity of the population, suppositories and digital stimulation have been reported as constipation treatment options in patients with a double diagnosis of ABI and SCI (Valbuena Valecillos et al, 2022) and these can be regarded as first-line therapeutic choices.…”

Section: Management Of Nbdmentioning

confidence: 99%

“…Due to the scarcity of literature and heterogeneity of existing data on ABI NBD ( Coggrave et al, 2014 ; Valbuena Valecillos et al, 2022 ), a scoping review was planned. The present scoping review aimed to underline the type and entity of evidence regarding bowel dysfunction after brain injury and to present treatment options (except surgery).…”

Section: Introductionmentioning

confidence: 99%

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Bowel dysfunctions after acquired brain injury: a scoping review

Zandalasini,

Pelizzari,

Ciardi

et al. 2023

Front. Hum. Neurosci.

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Bowel dysfunction is a common consequence of neurological diseases and has a major impact on the dignity and quality of life of patients. Evidence on neurogenic bowel is focused on spinal cord injury and multiple sclerosis; few studies have focused on patients with acquired brain injury (ABI). Neurogenic bowel dysfunction is related to a lifelong condition derived from central neurological disease, which further increases disability and social deprivation. The manifestations of neurogenic bowel dysfunction include fecal incontinence and constipation. Almost two out of three patients with central nervous system disorder have bowel impairment. This scoping review aims to comprehend the extent and type of evidence on bowel dysfunction after ABI and present conservative treatment. For this scoping review, the PCC (population, concept, and context) framework was used: patients with ABI and bowel dysfunction; evaluation and treatment; and intensive/extensive rehabilitation path. Ten full-text articles were included in the review. Oral laxatives are the most common treatment. The Functional Independence Measure (FIM) subscale is the most common scale used to assess neurogenic bowel disease (60%), followed by the Rome II and III criteria, and the colon transit time is used to test for constipation; however, no instrumental methods have been used for incontinence. An overlapping between incontinence and constipation, SCI and ABI increase difficulties to manage NBD. The need for a consensus between the rehabilitative and gastroenterological societies on the diagnosis and medical care of NBD.Systematic review registration Open Science Framework on August 16, 2022 https://doi.org/10.17605/OSF.IO/NEQMA.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Management Of Nbdmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Bowel dysfunctions after acquired brain injury: a scoping review

Zandalasini,

Pelizzari,

Ciardi

et al. 2023

Front. Hum. Neurosci.

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“…21 Consistent with previous reports, motor vehicle crashes accounted for 44.4% of patients with concomitant TBI and tSCI. 22 This is to be expected given the significant force associated with this mechanism of injury. This pattern differed from patients with tSCI without TBI, who were more frequently admitted to the hospital after falls (51.2%).…”

Section: Discussionmentioning

confidence: 96%

Concomitant Traumatic Brain Injury Delays Surgery in Patients With Traumatic Spinal Cord Injury

Azad,

Raj,

Ran

et al. 2024

Neurosurgery

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BACKGROUND AND OBJECTIVES: Growing evidence supports prompt surgical decompression for patients with traumatic spinal cord injury (tSCI). Rates of concomitant tSCI and traumatic brain injury (TBI) range from 10% to 30%. Concomitant TBI may delay tSCI diagnosis and surgical intervention. Little is known about real-world management of this common injury constellation that carries significant clinical consequences. This study aimed to quantify the impact of concomitant TBI on surgical timing in a national cohort of patients with tSCI. METHODS: Patient data were obtained from the National Trauma Data Bank (2007-2016). Patients admitted for tSCI and who received surgical intervention were included. Delayed surgical intervention was defined as surgery after 24 hours of admission. Multivariable hierarchical regression models were constructed to measure the risk-adjusted association between concomitant TBI and delayed surgical intervention. Secondary outcome included favorable discharge status. RESULTS: We identified 14 964 patients with surgically managed tSCI across 377 North American trauma centers, of whom 2444 (16.3%) had concomitant TBI and 4610 (30.8%) had central cord syndrome (CCS). The median time to surgery was 20.0 hours for patients without concomitant TBI and 24.8 hours for patients with concomitant TBI. Hierarchical regression modeling revealed that concomitant TBI was independently associated with delayed surgery in patients with tSCI (odds ratio [OR], 1.3; 95% CI, 1.1-1.6). Although CCS was associated with delayed surgery (OR, 1.5; 95% CI, 1.4-1.7), we did not observe a significant interaction between concomitant TBI and CCS. In the subset of patients with concomitant tSCI and TBI, patients with severe TBI were significantly more likely to experience a surgical delay than patients with mild TBI (OR, 1.4; 95% CI, 1.0-1.9). CONCLUSION: Concomitant TBI delays surgical management for patients with tSCI. This effect is largest for patients with tSCI with severe TBI. These findings should serve to increase awareness of concomitant TBI and tSCI and the likelihood that this may delay time-sensitive surgery.

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