Question

State the Etiology, Prognosis, and Complications for Spinal Cord Injury, Dementia and Acquired Brain Injury.

Answer 1

SPINAL CORD INJURY

A spinal cord injury is damage to any part of the spinal cord or nerves at the end of the spinal canal(cauda equina) often causes permanent changes in strength, sensation and other body functions below the site of the injury

Etiology

• Damage to the vertebrae, ligaments or discs of the spinal column or to the spinal cord itself
• A traumatic spinal cord injury may stem from a sudden, traumatic blow to the spine that fractures, dislocates , crushes or compresses one or more of the vertebrae.
• A non traumatic spinal cord injury may be caused by arthritis, cancer, inflammation, infections or disk degeneration of the spine
• Additional damage occurs because of bleeding, swelling, inflammation and fluid accumulation in and around the spinal cord

Complications

• Bladder control: Bladder will continue to store urine from the kidneys but brain may not be able to control the bladder as well because the message carrier has been injured
• Bowel control: Although stomach and intestines work much like they did before the injury, control of the bowel movements is often altered.
• Skin sensation: Below the neurological level of the injury, there may have lost part of or all skin sensations.
• Circulatory control: A spinal cord injury may cause circulatory problems ranging from low blood pressure when you rise to swelling of the extremities
• Respiratory system: Injury may make it more difficult to breathe and cough if the abdominal and chest muscles are affected
• Muscle tone: Some people with spinal cord injuries experience one of the 2 types of muscle tone problems; uncontrolled tightening or motion in the muscles or soft and limp muscles lacking muscle tone
• Fitness and wellness: Weight loss and muscle atrophy are common soon after a spinal cord injury
• Sexual health: Fertility and sexual function may be affected by a spinal cord injury
• Pain: Muscle pain, joint pain from overuse of particular muscle groups
• Depression: Copying with all the changes a spinal cord injury brings and living with pain causes some people to experience depression.

Prognosis

• Patients with a complete spinal cord injury have less than 5% chance of recovery
• The prognosis is much better for the incomplete cord syndromes
• If some sensory function is preserved, the chance that the patient will wventually be able to walk is greater than 50%
• Ultimately , 90% of patients with spinal cord injury return to their homes and regain independence

DEMENTIA

Dementia describes a group of symptoms affecting memory, thinking and social abilities severely enough to interfere with the daily life.

Etiology

• Dementia can be caused by damage to or loss of nerve cells and their connections in the brain.
• Alzheimer's disease is the most common cause of a progressive dementia in older adults.
• Caused by reaction to medications or vitamin deficiencies .

Complications

• Poor nutrition: Many people with dementia eventually reduce or stop eating affecting their nutrition intake. Ultimately they may be unable to chew and swallow
• Pneumonia: Difficulty swallowing increases the risk of choking or aspirating food into the lungs, which can block breathing and cause pneumonia
• Inability to perform self- care tasks: As dementia progresses, it can interfere with bathing, dressing, brushing hair or teeth, using the toilet independently and taking medications accurately
• Personal safety challenges: Some day to day situations can present safety issues for people with dementia, including driving, cooking and walking alone
• Death: Late stage dementia results in coma and death , often from infection.

Prognosis

• Dementia is a severe disease with often a poor prognosis
• Mortality risks are estimated to be atleast two times higher than mortality risks in non- demented patients.

ACQUIRED BRAIN INJURY

Traumatic brain injury usually results from a violent blow or jolt to the head or body.

Etiology

• Falls
• Vehicle related collisions
• Violence
• Sports injuries
• Explosive blasts and other combat injuries

Complications

• Coma: A person in coma is unconscious , unaware of anything and unable to respond to any stimulus
• Vegetative state: Widespread damage to the brain can result in a vegetative state.
• Brain death: When there is no measurable activity in the brain and the brainstem, this is called brain death.
• Seizures: Some people with traumatic brain injury will develop seizures
• Fluid buildup in the brain: Cerebrospinal fluid may build up in the spaces in the brain
• Infections: Skull fractures or penetrating wounds can tear the layers of protective tissues that surround the brain.
• Blood vessel damage: Several small or large blood vessels in the brain may be damaged in a traumatic brain injury
• Headaches: Frequent headaches are very common after a traumatic brain injury
• Vertigo: Many people experience vertigo, a condition characterized by dizziness after a traumatic brain injury

Prognosis

Mild cases may result in a brief change in mental state or consciousness

Severe cases may result in extended periods of unconsciousness, coma, or even death.