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Review of the secondary injury theory of acute spinal cord trauma with emphasis on vascular mechanisms
TATOR CH; FEHLINGS M
J NEUROSURG , 1991, vol. 75, n° 1, p. 15-26 Doc n°: 52487 Localisation : Documentation IRR Descripteurs : AE2 - PARAPLEGIE-TETRAPLEGIE In patients with spinal cord injury, the primary or mechanical trauma seldom causes total transection, even though the functional loss may be complete. In addition, biochemical and pathological changes in the cord may worsen after injury. The systemic effects of acute spinal cord injury include hypotension and reduced cardiac output. The local effects include loss of autoregulation in the injured segment of the spinal cord and a marked reduction of the microcirculation in both gray and white matter, especially in hemorrhagic regions and in adjacent zones. The microcirculation loss extends for a considerable distance proximal and distal to the site of injury. These posttraumatic vascular effects can be treated. Systemic normotension can be restored with volume expansion or vasopressors, and spinal cord blood flow can be improved with dopamine, steroids, nimodipine, or volume expansion. Langue : ANGLAIS Identifiant basis : 1991001548 |
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