The name of the disorder is nervous system injury. These are injuries to the central nervous system which might damage the spinal cord or the brain. If the injury is not severe, the individual might recover fully. If the injury is severe, death might occur, or the individual might be disabled permanently. The spinal cord and brain injuries usually occur due to accidents or crashes. An individual who has attained a severe injury of the brain suffers permanent brain damage. The injuries on the brain occur when the individual is hit by an external force, for instance, a violent blow or jolt to the body or head, which causes the brain to be dysfunctional. Traumatic injury in the brain can be caused by an object which might penetrate the skull, for example, a skull piece that is shattered or a bullet. Therefore, the individual might have trouble controlling body movements or having difficulty talking (Kumar et al., 2018). Symptoms depend on the part of the brain that was injured. Severe brain injuries can cause mental abilities problems such as memory loss and change in personality.
Counselling, medicines, and various treatments can help individuals who have brain injuries to recover and cope with their disabilities. Spinal cord injuries are damages that have occurred on any part of the nerves at the end of the spinal canal or any part of the spinal cord. The injuries cause irreversible changes in the body's sensation, strength, and other functions below the injury site. Injuries in the spinal cord make it difficult for messages to travel between the body and the brain. Moreover, they might cause an individual to lose the ability to move or feel parts of the body, often known as paralysis (Kumar et al., 2018). Paralysis depends on the seriousness of the location of the injury in the body parts of an individual. However, some individuals might recover from injuries of the spinal cord.
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2. Explanation
Emilio Smith, an 18-year-old student in high school, fell from a cliff that was 30 feet tall and sustained injuries to his body. The impact of the fall led to the impairment of his psychomotor skills and his limbs such that he could not feel his arms or legs. Paralysis below the neck is known as quadriplegia. The ability to control the limbs depends on the severity of the spinal cord injury and the place of damage along the spinal cord. Damage of the spinal cord affects an individual socially, physically, mentally, and emotionally. The injuries in the spinal cord were characterized by loss of mobility and changed sensation, which included the loss of “ability to touch, feel cold or heat”, inability to contract and expand his chest cavity.
Moreover, Emilio cannot move his body beyond the extremities, has general body discomfort and severe pains in the neck. “The spinal cord is responsible for sending messages to all” body parts from the brain and also send information from the body to the brain (Kumar et al., 2018). Moreover, an individual’s body can move their limbs and perceive pain since messages are sent via the spinal cord. Thus, if the spinal cord sustains an injury, the impulses are not sent to and from the body, which results in the total or complete loss of mobility and sensation below the injury (Kumar et al., 2018). An injury of the spinal cord sustained near the neck causes “paralysis throughout the larger parts of the body than one in the lower back area as his spinal cord injury” occurred due to trauma from falling over a significant height. However, Emilio was not paralyzed as some of his body parts were receiving impulses, and only his hands and feet were not receiving impulses. His injuries in the spinal cord severed the nerves which are involved in the transmission of impulses.
3. Causes/ Risks Factors
The nervous system injury might have been caused by damage to the spinal column discs, vertebrae, ligaments, or the spinal cord itself. The trauma from the fall over a cliff might have fractured, crushed, dislocated, or compressed one or more of the spinal vertebrae. Moreover, additional damage might have occurred due to fluid accumulation, swelling, bleeding, and inflammation in and around the spinal cord (Dewey, 2020). The nerve fibres might have been damaged, which might have impaired all of the corresponding or part of the nerves and muscles below the site of the injury.
The injury to the neck might have affected the movement of the arms. Moreover, the chest injury whereby Emilio was unable to expand or contract his chest while breathing might have affected the movement of his legs.
Even though spinal cord injury commonly occurs as a result of crashes and accidents, some factors might have been put Emilio at risk. The factors include:
Being male, as research by Dewey (2020) has shown that injuries of the spinal cord most commonly affect men. He also affirms that nervous system injuries in females account for only 20% in the United States of America.
Engaging in risky behaviour whereby playing or engaging in risky sports such as rock climbing, thought the individual wearing protective gears could result in injuries of the spinal cord.
Being between the ages of 16 and 30 as individuals between ages 16 and 30 is most likely to suffer injuries of the nervous system. Forty-three years is the average age at which an individual can obtain spinal injuries.
Other questions that I might have asked Emilio to obtain more information might be;
Have you ever experienced any nervous injury before?
Are you prone to any violence which might cause you to have a spinal injury?
4. Clinical Manifestation
The clinical manifestations that are present in Emilio are:
Paralyzed limbs such that he does not feel his arms and legs.
He could not move his body beyond the extremities.
Severe pains in the neck.
General discomfort.
Blurred vision.
Equal and unresponsive pupils to light.
Inability to expand and compress his chest cavity when breathing in and out, respectively.
5. Diagnostic Procedures
The patient was examined by careful examination and evaluation, whereby the medical physician asked him some questions concerning the accident and tested him for sensory movement and function. The patient was then checked to make sure that he was breathing properly and that there were no foreign objects blocking his air pathways. Also, the doctor examined Emilio’s neurological function. The sensation and strength of the patient’s arms and legs were also tested. Since the patient was weak and could not move, his neck collar was kept in place to avoid further injury to the neck. The cervical collar was rigid in order to hold his neck firmly into place, and he was then placed on a spine board so that he would be assessed fully through imaging.
The patient was then put on a high dose of steroids, which according to Dewey (2020), helps reduce the amount of the nervous system injury by lessening the swelling and inflammation. Then Emilio was placed in a halo device or traction around his head to prevent further damage of the spinal cord and keep the spine stable.
Surgery could be beneficial whereby the spinal cord becomes relieved of its pressure. This would comprise of removing pieces of the vertebrae that might have broken and were compressing the spinal cord (Dewey, 2020). Moreover, the surgery could help stabilize the spinal cord was the vertebrae might have been weakened by its fracture, which might have made it unable to fully support the weight of the patient and protect itself.
A combination of plates, metal screws, and rods were useful in holding the vertebrae together and making them stable until all the bones are completely healed.
After the initial stabilization and treatment of the patient with the nervous system injury, additional treatment necessitates rehabilitation. It includes aiding the patients in maximizing their functions via occupational therapy whereby aiding devices are utilized, such as using a wheelchair.
Other tests that I would have ordered might be:
X-rays, whereby the tests are ordered by medical personnel on patients who have experienced trauma or an injury in their nervous system. The use of X- rays shows the spinal cord columns fractures, degenerative changes, tumors, and problems in the spine.
Computerized tomography (CT) scan whereby the scan provides a clear look at the abnormalities seen by the X-ray (Kumar et al., 2018). The scan utilizes computers that form “cross-sectional images that can define disk, bone, and other problems”.
Magnetic resonance imaging (MRI) whereby the imaging utilizes the use of “radio waves and a strong magnetic field to produce images” that are generated by a computer (Cassar-Pullicino & Leone, 2017). The test aids in the identification of herniated discs, masses, and blood clots which might be putting pressure on the spinal cord.
After a few days after the swelling has gone down, the medical physician might perform a more comprehensive neurological exam to determine the completeness and the level of the injury. The testing comprises of testing the ability to sense light touch, the strength of the muscles and pinprick sensations.
References
Cassar-Pullicino, V. N., & Leone, A. (2017). Imaging in pediatric spinal injury. Trauma , 19 (1_suppl), 50-74.
Dewey, C. W. (2020). Spinal Injury. In the Veterinary ICU Book (pp. 921-934). CRC Press.
Kumar, R., Lim, J., Mekary, R. A., Rattani, A., Dewan, M. C., Sharif, S. Y., ... & Park, K. B. (2018). Traumatic spinal injury: global epidemiology and worldwide volume. World neurosurgery , 113 , e345-e363.
