Traumatic Injuries to the Spinal Cord and Peripheral Nervous System - 18/11/20

Doi : 10.1016/j.emc.2020.09.001

Lucas Sjeklocha, MD ^a, J. David Gatz, MD ^b,^⁎
^a R Adams Cowley Shock Trauma Center, 22 South Greene Street, Room S4D03, Baltimore, MD 21201, USA
^b Department of Emergency Medicine, University of Maryland School of Medicine, 110 South Paca Street, 6th Floor, Suite 200, Baltimore, MD 21201, USA

^∗Corresponding author.

Résumé

Both blunt and penetrating trauma can cause injuries to the peripheral and central nervous systems. Emergency providers must maintain a high index of suspicion, especially in the setting of polytrauma. There are 2 major classifications of peripheral nerve injuries (PNIs). Some PNIs are classically associated with certain traumatic mechanisms. Most closed PNIs are managed conservatively, whereas sharp nerve transections require specialist consultation for urgent repair. Spinal cord injuries almost universally require computed tomography imaging; some require emergent magnetic resonance imaging. Providers should work to minimize secondary injury. Surgical specialists are needed for closed reduction, surgical decompression, or stabilization.

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Keywords : Peripheral nerve injury, Spinal cord injury, Trauma, Neurogenic shock, Secondary injury