Neural Regeneration Research ›› 2015, Vol. 10 ›› Issue (6): 859-861.doi: 10.4103/1673-5374.158329

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Strategies to avoid a missed diagnosis of co-occurring concussion in post-acute patients having a spinal cord injury

David S. Kushner   

  1. Department of Physical Medicine & Rehabilitation, University of Miami Miller School of Medicine, Miami, FL, USA
  • Received:2015-04-13 Online:2015-06-18 Published:2015-06-18
  • Contact: David S. Kushner, M.D., dkushner@med.miami.edu.
  • Supported by:

    Department of Physical Medicine & Rehabilitation funding by the United States Department of Education, National Institute of Disability Research and Rehabilitation # H133A120099 (TBI Model Systems grant).

Abstract:

Research scientists and clinicians should be aware that missed diagnoses of mild-moderate traumatic brain injuries in post-acute patients having spinal cord injuries may approach 60–74% with certain risk factors, potentially causing clinical consequences for patients, and confounding the results of clinical research studies. Factors leading to a missed diagnosis may include acute trauma-related life-threatening issues, sedation/intubation, subtle neuropathology on neuroimaging, failure to collect Glasgow Coma Scale scores or duration of posttraumatic amnesia, or lack of validity of this information, and overlap in neuro-cognitive symptoms with emotional responses to spinal cord injuries. Strategies for avoiding a missed diagnosis of mild-moderate traumatic brain injuries in patients having a spinal cord injuries are highlighted in this perspective.

Key words: traumatic brain injury, spinal cord injuries, dual diagnosis, diagnosis, complications, rehabilitation, post-concussion syndrome, brain concussion