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Current Neurology and Neuroscience Reports

Erschienen in:

01.09.2019 | Neurotrauma (D. Sandsmark, Section Editor)

Modern Medical Management of Spinal Cord Injury

verfasst von: Michael Karsy, Gregory Hawryluk

Erschienen in: Current Neurology and Neuroscience Reports | Ausgabe 9/2019

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Abstract

Purpose of Review

Spinal cord injury (SCI) shows an incidence of 10.4–83 cases/million/year globally and remains a significant source of morbidity and cost to society. Despite greater understanding of the pathophysiology of SCI, neuroprotective and regenerative approaches to treatment have had limited clinical utility to date. Here, we review the key components of supportive care that are thus the mainstay of therapy and that have improved outcomes for victims of acute SCI in recent decades.

Recent Studies

Current management strategies for acute SCI involve early surgical decompression and fixation, the use of vasopressor medications for mean arterial blood pressure (MAP) augmentation to improve spinal cord perfusion, and corticosteroids. We highlight recent literature supporting the role of norepinephrine in acute SCI management and also an emerging neurocritical care strategy that seeks to optimize spinal cord perfusion pressure with the assistance of invasive monitoring.

Summary

This review will highlight key pathophysiologic principles and targets for current acute clinical treatments in SCI, which include early surgical decompression, MAP augmentation, and corticosteroids. We discuss anticipated future research in these areas and focus on potential risks inherent to these treatments.

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Titel: Modern Medical Management of Spinal Cord Injury
verfasst von: Michael Karsy
Gregory Hawryluk
Publikationsdatum: 01.09.2019
Verlag: Springer US
Erschienen in: Current Neurology and Neuroscience Reports / Ausgabe 9/2019
Print ISSN: 1528-4042
Elektronische ISSN: 1534-6293
DOI: https://doi.org/10.1007/s11910-019-0984-1

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Abstract

Purpose of Review

Recent Studies

Summary

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