Evaluation and Management of the Patient with Craniomaxillofacial Trauma

Spinal cord injury (SCI) is prevalent worldwide and has the potential to cause significant disability or death in affected patients. Due to the high forces required to disrupt the spinal column, diagnosis and treatment of SCI is commonly performed in conjunction with other traumatic injuries, thus requiring a systematic approach and coordination among surgeons and other members of the treatment team. CT is the primary imaging modality used to evaluate these patients, though radiographs and MRI also play a role. SCI is often classified according to the American Spinal Injury Association (ASIA) classification, which grades patients A-E according to the severity of neurologic deficit. The decision-making algorithm of when and how quickly to pursue surgical treatment is complex and dependent on the level of injury, type of injury, and severity of neurologic deficits. The use of corticosteroids in acute SCI remains controversial, but current guidelines suggest that early administration of a 24-hour infusion may improve neurologic recovery. Many complications may result from SCI due to denervation, lack of mobility, and psychological distress; early evaluation and treatment from rehabilitation specialists is an essential part of recovery for both patients and family members.