Which conditions should be included in the differential diagnoses of spinal cord injury (SCI)?

Updated: Nov 01, 2018
  • Author: Lawrence S Chin, MD, FACS; Chief Editor: Brian H Kopell, MD  more...
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Answer

Attributing hypotension to neurogenic shock in the setting of spinal cord injury (SCI) is a potentially devastating error. As noted under Clinical, before hypotension can be attributed to neurogenic shock, a diligent search for sources of hemorrhage must be completed. Shock may be hemorrhagic, neurogenic, or both in patients with acute spinal cord injury.

The presence of vital sign confusion in acute spinal cord injury coupled with the limitations of the physical examination can make the diagnosis of hemorrhage from associated injuries challenging.

Also consider other conditions in patients with suspected spinal cord injury, such as transverse myelitis, acute intervertebral disk herniation, and extradural spinal cord compression.


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