Abstract
Traumatic injury to the central nervous system (CNS) is one of the most important issues concerning the health care system in the 1990s and will likely remain so into the next millenium. In the United States, there are 10,000 hospital admissions each year secondary to spinal cord injury (SCI), while there are more than 250,000 hospital admissions each year secondary to traumatic brain injury (TBI). The majority of SCIs occur in the young, and 55% of traumatic SCIs are sustained by people between 16 and 30 years old. A similar trend is noted in TBI with the highest incidence rate reported for those who are between 15 and 24 years old. Motor vehicle accidents (MVAs) and falls are the two most common causes of traumatic injuries to the CNS. Recent advances have lessened the incidence of MVAs related to the CNS, while there has been an increased rate of injury secondary to violence in both SCI and TBI. The issue of dual diagnosis of SCI and TBI is an important one. It is far more common for the patients with an SCI to also have a TBI diagnosed, with a rate between 24% and 50% reported. The converse of SCI diagnosed after a primary TBI is much less common with single digit rates between 1.2% and 6% reported.
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