Review of the secondary injury theory of acute spinal cord trauma with emphasis on vascular mechanisms.

  title={Review of the secondary injury theory of acute spinal cord trauma with emphasis on vascular mechanisms.},
  author={Charles Tator and Michael G. Fehlings},
  journal={Journal of neurosurgery},
  volume={75 1},
In patients with spinal cord injury, the primary or mechanical trauma seldom causes total transection, even though the functional loss may be complete. In addition, biochemical and pathological changes in the cord may worsen after injury. To explain these phenomena, the concept of the secondary injury has evolved for which numerous pathophysiological mechanisms have been postulated. This paper reviews the concept of secondary injury with special emphasis on vascular mechanisms. Evidence is… 

Spinal cord blood flow and evoked potentials as outcome measures for experimental spinal cord injury

One of the most direct methods of observing the spinal cord ischemia caused by SCI is to measure spinal cord blood flow (SCBF), which has considerable supporting evidence based on biochemical, pathological, angiographic, blood blow and therapeutic studies.

Considerations for Spinal Cord Injury in the Athlete

The interventions most commonly used today include surgery, maintaining high perfusion pressures, intravenous steroids, and induced hypothermia, and other medical modalities have been investigated with mixed results at this time.

Current and future surgery strategies for spinal cord injuries.

The aim of the surgery is to decompress the spinal channel and to restore the spinal alinement and mobilize the patient as soon as possible and use of neuroprotective agents as well as methods to achieve cell regeneration in addition to surgery would contribute to the solution.

Vascular mechanisms in the pathophysiology of human spinal cord injury.

These studies implicate damage to the anterior sulcal arteries in causing the hemorrhagic necrosis and subsequent central myelomalacia at the injury site in acute spinal cord injury in humans.

Secondary injury mechanisms in traumatic spinal cord injury: a nugget of this multiply cascade.

  • C. Oyinbo
  • Medicine, Biology
    Acta neurobiologiae experimentalis
  • 2011
This article has cataloged over twenty five identified secondary mechanisms of injury in the spinal cord in an open access portal, and is particularly versatile for starters in spinal cord injury research.

Acute Spinal Cord Injury, Part I: Pathophysiologic Mechanisms

The first article in this series will comprehensively review the pathophysiology of SCI while emphasizing those mechanisms for which pharmacologic therapy has been developed, and the second article reviews the pharmacologic interventions for SCI.

The case for surgery of the injured spine in the management of traumatic cord injuries

It is argued that early surgery for spinal cord injury with continued cord compression offers significant benefit and should be undertaken when not contraindicated.

Mechanisms of injury and emergency care of acute spinal cord injury in dogs and cats.

The prognosis for acute spinal injury is varied and is dependent upon the presence of concurrent trauma, location, and type of primary injury sustained, and extent of neurologic impairment at the time of initial presentation.



Spinal cord injury. Review of basic and applied research.

This review examines, in a condensed manner, many of the major achievements related to spinal cord injury research during the last quarter century, including such basic and clinical tools as evoked potentials, regional and local spinal blood flows, neurophysiologic monitoring systems, and methods that detail the morphology and contents of cord tissue.

Pathology of spinal injuries.

  • B. Kakulas
  • Medicine
    Central nervous system trauma : journal of the American Paralysis Association
  • 1984
Although in very severe injuries complete disruption of both bony and spinal cord tissues was observed, others with equally massive injuries showed some continuity of the spinal cord parenchyma, somewhat unexpected observation is in accord with physiologic studies in which poly EMG and sensory-evoked potentials demonstrate continuity of long tracts across the lesion in patients who were otherwise clinically complete.

Experimental treatments of acute spinal cord injury.

Standard dural decompression, direct local cord hypothermia, intramuscular dexamethasone, and intrathecal methylprednisolone are evaluated.

Acute Spinal Cord Injury in the Rat: Comparison of Three Experimental Techniques

  • Moe KhanR. Griebel
  • Medicine
    Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques
  • 1983
The weight dropping technique was found unreliable for experimental spinal cord injury in the rat while the aneurysm clip compression technique resulted in consistent cord injuries with respect to subsequent clinical recovery.

Microangiographic study of experimental spinal cord injuries.

The evidence indicates that at all times in the pathogenesis of spinal cord injury the microvasculature in Zone 2 is capable of perfusion.

The histopathology of experimental spinal cord trauma. The effect of systemic blood pressure.

The marked enhancement or retardation of hemorrhages in the post-injury period, when the blood pressure was increased or decreased, respectively, demonstrates the loss of autoregulation of spinal cord vasculature at the trauma site after a concussive paraplegic injury.

Relationship between posttraumatic ischemia and hemorrhage in the injured rat spinal cord as shown by colloidal carbon angiography.

The results suggest that ischemic lesions in the white matter are anatomically related to hemorrhagic lesions in a relationship unknown, but may include thrombosis, vasospasm, or direct injury of the feeding vessels.

Altered blood flow and secondary injury in experimental spinal cord trauma.

This investigation not only confirms the presence of ischemia in the lateral funiculus of the injured spinal cord but suggests that a period of time exists in the posttraumatic period during which pharmacological intervention may alter the ischemic response and possibly prevent secondary injury resulting from theIschemia.

Management of acute spinal cord injuries.

The unit has achieved a marked reduction in both mortality and morbidity and the study confirms the advantages of regionalization and specialization in the field of acute spinal cord injury.

Hemorrhagic Changes in Experimental Spinal Cord Injury Models

ABSTRACT: Early hemorrhagic changes in the spinal cord were compared in three experimental spinal cord injury models in the rat in order to determine the nature and consistency of spinal cord