Traumatic Brain Injury in Spinal Cord Injury: Frequency and Risk Factors

作者：Bojana Budisin, Cheryl C.L.B Bradbury, Bhanu Sharma, Sander L. Hitzig, David J. Mikulis, B. Catharine Craven, Colleen McGilivray, Jasmine Corbie, Robin Green · 发表于：Journal of Head Trauma Rehabilitation · 年份：2015 · DOI：10.1097/htr.0000000000000153 · 被引用次数：42 · 研究领域：Traumatic Brain Injury Research、Spinal Cord Injury Research、Traumatic Brain Injury and Neurovascular Disturbances

BACKGROUND: The frequency of traumatic brain injury (TBI) co-occurring with traumatic spinal cord injury (tSCI) is unclear despite a number of past studies; as well, limited research has examined predictors of co-morbid TBI in tSCI patients. OBJECTIVES: (1a) To summarize past literature on comorbid diagnosis of TBI in tSCI in order to reexamine the frequency of dual diagnosis in a study designed to obviate past methodological limitations; (1b) to compare dual-diagnosis frequency with vs without the inclusion of diagnostically ambiguous cases; and (2) to measure risk factors for tSCI and comorbid TBI. METHODS: Ninety-one of 135 eligible adults with tSCI, 3 to 6 months postinjury, were prospectively recruited from a tertiary inpatient tSCI rehabilitation program. TBI diagnosis was based on comprehensive, validated clinical neurological and neuroimaging measures. RESULTS: Objective 1: 39.6% of the tSCI patients sustained a concomitant TBI, but when ambiguous cases were removed from analysis, frequency rose to 58.1%. Objective 2: Motor vehicle collisions were most likely to yield a comorbid TBI diagnosis, but 31.6% of falls also resulted in TBI. Patients with cervical and thoracic injuries showed a very similar frequency of comorbid TBI. CONCLUSIONS: Varied methodological approaches, particularly the decision to include/exclude ambiguous cases, likely explain disparate past estimates of TBI in tSCI. However, even this study's lower frequency estimate, at nearly 40%, is clinically...