Abstract
Research findings and clinical experience obtained over the past 20 years have clearly established the principles of brain resuscitation in the management of closed head injuries. It is proposed that with regard to resulting morbidity, the same pathophysiological and mechanistic phenomena occur in acute spinal cord trauma. Specifically, it is secondary cord injury caused by hypoxia, edema, and aberrations in cell membrane potential that are largely responsible for resulting neurological deficits. The concept of spinal cord resuscitation is proposed as an attempt to reverse secondary changes that occur to obtain maximal neurological recovery. Such measures would include (1) prompt relief of cord deformation, (2) administration of intravenous corticosteroids, and (3) initiation of measures to facilitate spinal cord perfusion.
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