SCCM Resource Library-CCE: Acute Spinal Cord Emergencies

Pdf Summary

The document outlines the management of acute spinal cord emergencies, focusing on both traumatic and non-traumatic causes. Key learning objectives include identifying clinical findings suggestive of spinal cord pathology, managing spinal cord compression, recognizing spinal cord infarction, and treating neurogenic shock.<br /><br />It emphasizes the importance of early collaboration with neurosurgical and neurovascular teams for effective management. Initial assessments look for signs such as flaccid weakness, sensory loss, abnormal reflexes, and potential respiratory compromise.<br /><br />The ASIA Impairment Scale classifies the severity of spinal cord injuries to track progress and aid in prognosis. Immediate management involves stabilization of the cervical spine if involved, blood pressure management to ensure adequate spinal cord perfusion, and neurosurgical consultation.<br /><br />Neurogenic shock, resulting from disrupted sympathetic pathways, manifests as hypotension and bradycardia. It requires blood pressure support using vasopressors like phenylephrine and norepinephrine and management of bradycardia.<br /><br />Case studies provide practical scenarios for managing traumatic and non-traumatic spinal injuries, illustrating the need for appropriate imaging (CT or MRI), hemodynamic stabilization, and immediate intervention.<br /><br />Non-traumatic spinal cord injuries may arise from degenerative pathologies, malignancies, or infections, and often require high-dose IV steroids and antibiotics along with neuroimaging.<br /><br />Spinal cord infarctions present with acute weakness and sensory deficits, requiring immediate CT imaging to rule out hemorrhage followed by MRI for confirmation. Management focuses on supporting spinal cord perfusion through BP augmentation and lumbar drainage.<br /><br />Key management strategies include maintaining a mean arterial pressure of 80-85 mmHg, prioritizing respiratory status, and selection of the correct imaging modality for timely diagnosis. Early consultation with specialists is critical across various cases to mitigate further injury and optimize outcomes.

Asset Subtitle

Neuroscience, 2024

Meta Tag

Content Type Presentation

Knowledge Area Neuroscience

Membership Level Professional

Membership Level Select

Tag Spinal Cord Injury

Tag Neurology

Year 2024

Keywords

acute spinal cord emergencies

spinal cord pathology

spinal cord compression

neurogenic shock

ASIA Impairment Scale

neurosurgical consultation

hemodynamic stabilization

non-traumatic spinal injuries

spinal cord infarctions

mean arterial pressure

Presentation

Neuroscience

Spinal Cord Injury

Neurology

2024

Professional

Select

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