Abstract
Spinal cord lesions after injuries are usually indirect phenomena and secondary to fractures, dislocations, distortions of the vertebrae (Kocher 1 ), rupture of the intervertebral cartilages or ligaments, meningeal and intraspinal hemorrhages. In many cases, a trauma, such as a blow, fall or shell explosion affects the spinal cord directly, producing structural nerve changes without the intermediation of the foregoing factors. Such cases are termed concussion—a condition in which, as emphasized long ago by Obersteiner 2 and Schmaus, 3 a destructive action on the specific nerve elements obtains. In the majority of traumatic spinal cord lesions both direct and indirect factors are at play. For instance, the cervical region may be affected by a fractured or dislocated vertebra (indirect or intermediary action), the thoracic or lumbar regions exhibiting evidences of so-called concussion, a direct effect of the jarring of the spinal cord brought on by a trauma. 4 The clinical
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