Screening and outcomes of co-occurring traumatic brain injury among people with spinal cord injury: a scoping review.
Deborah L Snell, Phoebe Wynands, Jennifer Dunn and 2 others
PMID 39750040WHAT IT FOUND
Co-occurring brain injury is frequently missed in spinal cord injury patients due to poor documentation.
Mild injuries are hardest to detect. Outcomes are mixed, but moderate to severe cases often face longer stays and lower independence. Rely on multiple markers, not just one test.
Key findings
01Incomplete documentation of indicators like loss of consciousness and post-traumatic amnesia leads to underestimation of brain injury rates.
02Using multiple indicators together is more reliable for identification than relying on a single marker like the Glasgow Coma Scale.
03Patients with moderate to severe co-occurring brain injury often have longer rehabilitation stays and lower functional independence scores.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The review did not assess the quality of the included studies. Most studies were conducted in the United States, which may limit how well findings apply to other healthcare systems. The studies included spanned a long period (1987–2023), so diagnostic criteria and treatments varied significantly. Sample sizes in many individual studies were small, leading to mixed and inconsistent results. Few studies focused on children, so findings may not apply to paediatric populations.
Declared interests
The authors declared no conflicts of interest. The research was funded by the Health Research Council of New Zealand and a Future Health Researcher grant sponsored by Canterbury Orthopaedic Services.
The easy way to misread this
Do not assume that a normal initial screening or lack of documented brain injury in the acute phase means the patient has no cognitive impairment. The review found that mild brain injuries are frequently missed due to inconsistent documentation and overlapping symptoms with spinal cord injury.