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Spinal cord injury. Literature update: physiopathology and initial treatment. Equipo de Columna Vertebral. Hospital del Trabajador de Santiago.

The pathophysiology of spinal cord injury SCI is complex and still not fully elucidated. Primary and secondary processes determine SCI. The initial injury is produced by the transmission of the mechanical energy of the trauma to the spinal cord and neural structures.

The secondary injury acts on those structures that were spared by the initial trauma, affecting microvascular perfusion and ionic concentrations, inducing the liberation of free radicals and neurotransmitters and activating lipid peroxidation, thus producing cellular death.

Recent research in the treatment of SCI is focused on the development of timely therapeutic interventions that could attenuate the effects of these secondary pathophysiological mechanisms. Among the pharmacological interventions, methyl-prednisolone, gangliosides and antagonists of opiod, glutamate receptor and ionic channels have been used, advocating their theoretical protective effect in the neurological prognosis of patients with SCI.

Nevertheless, none of these interventions has yet significantly modified this prognosis. Fase Inmediata 0 - 2 horas. Fase Aguda 2 - 48 horas. Mediadores inflamatorios y respuesta inmune celular. Fase Intermedia 2 semanas a 6 meses. Manejo inicial del TRM. El uso de la MP, ampliamente recomendada, es debatible y no completamente soportado por la evidencia actual.

Hagg T, Oduega M. Degenerative and spontaneous regenerative processes after spinal cord injury. J Neurotrauma. Epidemiology, demographics, and pathophysiology of acute spinal cord injury. Spine Phila Pa Current status of acute spinal cord injury physiophysiology and emerging therapies: promise on the horizon. Neurosurg Focus. Tator CH, Koyanagi I. Vascular mechanisms in the pathophysiology of human spinal cord injury.

J Neurosurg. Ultra-early MRI showing no abnormality in a fall victim presenting with tetraparesis. Spinal Cord. Calcium dependence of toxic cell death: a final common pathway.

Excitatory amino acids as a final common pathway for neurologic disorders. N Engl J Med. Role of peroxynitrite in secondary oxidative damage after spinal cord injury. J Neurochem. Free radicals in CNS injury.

Cytokine-induced acute inflammation in the brain and spinal cord. J Neuropathol Exp Neurol. The cellular inflammatory response in human spinal cords after injury. Inflammation and its role in neuroprotection, axonal regeneration and functional recovery after spinal cord injury.

Exp Neurol. STAT3 is a critical regulator of astrogliosis and scar formation after spinal cord injury. J Neurosci. Degeneration and sprouting of identified descending supraspinal axons after contusive spinal cord injury in the rat. Ehlers MD. Deconstructing the axon: Wallerian degeneration and the ubiquitin-proteasome system. Trends Neurosci. Stoodley MA.

Pathophysiology of syringomyelia. Santiago: American College of Surgeons; ATLS R and damage control in spine trauma. World J Emerg Surg. Nockels RP. Nonoperative management of acute spinal cord injury. Pathophysiology and pharmacologic treatment of acute spinal cord injury. Spine J. Efficacy of methylprednisolone in acute spinal cord injury. A randomized, controlled trial of methylprednisolone or naloxone in the treatment of acute spinal-cord injury.

Methylprednisolone or naloxone treatment after acute spinal cord injury: 1-year follow-up data. Administration of methylprednisolone for 24 or 48 hours or tirilazad mesylate for 48 hours in the treatment of acute spinal cord injury.

Methylprednisolone or tirilazad mesylate administration after acute spinal cord injury: 1-year follow up. High dose methylprednisolone in the management of acute spinal cord injury - a systematic review from a clinical perspective. Bracken MB. Steroids for acute spinal cord injury. Cochrane Database Syst Rev. Skaper SD, Leon A. Monosialogangliosides, neuroprotection, and neuronal repair processes.

The Sygen multicenter acute spinal cord injury study. Chinnock P, Roberts I. Gangliosides for acute spinal cord injury. Systemic naloxone infusion may trigger spasticity in patients with spinal cord injury: case series. J Spinal Cord Med. Protection and repair of the injured spinal cord: a review of completed, ongoing, and planned clinical trials for acute spinal cord injury. Acute spinal cord injury: early care and treatment in a muticenter study with gacyclidine [abstract].

Soc Neurosci. Pharmacological therapy of spinal cord injury during the acute phase. All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License. Services on Demand Journal. Lorena, cj. How to cite this article.


Translation of "traumatismo vertebro medular" in English








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