Patients with spinal cord injuries present a unique set of challenges for medical management and rehabilitation. Loss of strength in the extremities requires a special focus on rehabilitation techniques to become as functionally independent as possible. Based on the deficits of the individual, there may be an emphasis on family training.
Patients experience many changes in their physiology, including gastrointestinal, genitourinary, cardiovascular, pulmonary, musculoskeletal, neurologic, and psychological changes that require regular monitoring. In this article, Dr. Michael Kryger of the University of Pittsburgh Medical Center and Dr. Amanda Harrington of the University of Pittsburgh Medical Center discuss how understanding these physiologic changes helps a practitioner successfully evaluate and treat patients with spinal cord injury.
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Neurovascular injury to the vertebral, basilar, and carotid arteries can occur either extra- or intracranially and can manifest as an arterial dissection, pseudoaneurysm, fistula formation, and thrombosis or occlusion of the involved vessel. In this clinical summary, Dr. Akash Patel and Dr. Edward Duckworth of Baylor College of Medicine, review the pathophysiological mechanisms and sequelae of these injuries, clinical presentation, modes of diagnosis, treatment strategies, and factors affecting prognosis. Primary methods of treatment include medical management and neuroendovascular intervention. Surgical options and current ongoing trials are also discussed.
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