CHAPTER 5 Nervous System^247
PROGNOSIS
The level of injury will determine the degree of disability the patient is likely to sus-
tain. A high-level injury, such as a cervical injury, will more likely result in quadra-
plegia (paralysis of all four extremities) and compromise of the respiratory drive.
A complete spinal cord injury will result in greater disability than an incomplete
injury. Spinal cord tissue does not regenerate after an injury. Swelling that occurs
immediately following an injury may be controlled with medications and some
clinical improvement may occur, but the damage to the cord cannot be undone.
HALLMARK SIGNS AND SYMPTOMS
- Loss of motor control due to damage to the anterior horn of the spinal cord
- Loss of reflexes due to damage of the spinal cord, the point of synaptic trans-
mission of sensory impulse to motor response - Flaccid paralysis
- Lack of bowel and bladder control
- Altered sensation (tingling—paresthesia; diminished—hypoesthesia; in-
creased—hyperesthesia) - Bradycardia, hypotension, hypothermia due to problems with the autonomic
nervous system
INTERPRETING TEST RESULTS
- MRI shows vertebral or spinal cord injury and edema.
- CT scan shows vertebral or spinal cord injury and edema.
TREATMENT
- Immobilize the affected area of the spinal cord to decrease chance of further
irritation. - Place the patient in a flat position to avoid flexion or misalignment of the
spine. - Monitor traction or collar to prevent skin irritation.
- Administer corticosteroid to decrease inflammation at point of injury:
- methylprednisolone