Spinal Stroke, Delayed Injury, Fibrocartilaginous Embolism

[Ronnoco]

Note on unexplained Spinal Injury & Spinal Stroke

Following extensive investigation of the causes of spinal strike without apparent explanation, the following case has been proven by a team of bio mech engineers, leading neurologists and other contributors in the spinal research field. A scientific paper is being prepared for publication.

1. Spinal stroke may occur many weeks or months after a primary event involving sudden straightening of the spine due to physical trauma such as impacts, sudden athletic overstrains, certain sports activities and other daily activity not providing immediate neurological symptoms.

2 The classic spinal stroke onset and symptoms may occur following subsequent minor overstrains or lesser impacts many weeks later. The detailed mecanism of sudden vascular obstruction is now established.

3. Aspirin at the time of final onset has been identified as one of the few medicines that should be administered according to latest published research.

4. anyone wishing with to obtain qualifying references for these comments should contact me directly for references and or the unpublished studies.

5. these phenomenon may account for up to 20% of spinal strokes.

6 There is now an established diagnosis protocol which should be observed in A & E before cauda equina or other potential diagnoses become dominant theories.


7. the full detailed physical history for 3 months prior to onset should be very carefully considered in diagnosis.

[Vintage]

I lived in nursing homes for a year and a half. During that time, I came in contact with several residents (patients) who had paralysis due to strokes. It seemed to me that the majority of those that I had exchanges with also had difficulty expressing themselves. When reading the above information, it occurred to me that doctors probably have a hard time questioning their patients to get that "full detailed physical history for 3 months prior to onset". You would be an exception in this regard, Romoco, as you seem very alert and articulate. But have you been around others who have had strokes, and have you seen examples of what I'm talking about?

[SCI-Nurse]

Ronnoco is referring to SPINAL CORD stroke, not brain stroke (CVA). Spinal cord stroke does not result in brain damage, so speech or cognition is not impaired.

(KLD)

[Ronnoco]

Hello
Any stroke can be traumatic and the ability to recall important details and tell tale signs is very difficult following a stroke event which is perceived as being the key event. The tell tale signs connected to mini stroke are vital indicators and links to prior trauma which may account for the origin of the injury. In my case, the ability to recall clearly and look past over months of events was by no means an easy task to think about, remain motivated about or express even though maintaining full cerebral cognitive function. When I did get to grips with what actually happened, I found that the persons who has immediately dealt with me had firmed viewed which became deeply embedded and intractable.

The process of investigation of spinal strokes could do with some kind of protocol with key questions built in. At the moment there is none such as far as I am aware and thus may becoart of a future work in which I am involved.

Eventually a specialist recognised what I had to say and found value in it.

[Vintage]

Yes, I wasn't aware of spinal cord stroke. I was hit by a car. Then had two surgeries, and was put on oxycodone. Even without having a brain stroke, I lost count of time and would have had a hard time stringing together all the events in my recent history. When I was able to access my email, I was amazed at some of my college-related balancing acts that had seemed so important at the time. I was fascinated that this was what I had written about myself...and this was without having had any stroke at all!

I'm glad you were able to re-trace your steps, Ronnoco, and I hope you will get to participate in that process of investigation.

I didn't quite understand this part of your post, Ronnoco. Would you expand on it, please?
"...I found that the persons who has immediately dealt with me had firmed viewed which became deeply embedded and intractable."

[Ronnoco]

Excusevthe typographical errors, my tablet uses predictive text in a foreign language.

What I mean is that on the day of arrival to hospital, I was asked what happened and I Made various comments about what I thought could be relevant. This became the dominant story in my medical history and was transcribed again and gain from hospital, after some day, weeks and months I recalled more detail about what happened beforehand.vi tried to get these new points added to the medical notes but they kept getting overlooked. I was blue in the face trying to get the real events into the medical notes knowing full well that what was on paper would count most in case a real specialist would come along and see a pattern which was most clear to me.

[Ronnoco]

And to put it more bluntly, anybody who suffers a spinal cord injury and sudden onset of dire symptoms, is also a lilely candidate for PTSD. This has the strong possibility to cause repressed memories, in other words when the doctors asked what happened, you may give a blurry inaccurate picture. This bas huge legal importance esp when giving evidence and entering proof for insurance. So the lawyer could be advised thaT patient is likely to be suffering PTSD. The physican may not be able to get basic information.

So what to do with the cases where a person arrives with sudden spinal onset symptoms but cannot give an account for it. It is my proposition that a protocol or exploratory investigation be undertaken within some kind of framework. For example, to ask the patient about physical trauma in past months, like falls off a bicycle, trips and falls, weighlifting, sudden jolts, etc and evaluate these with family involved. But also to stir memory with initial questions then revisit several times. Seems luxurious but spinaL injury causation could take yeas to prove. Early stage detail probing is very valuable.

[SCI-Nurse]

This thread is nearly 5 years old.
(KLD)

[Vintage]

Those are good points, Ronnoco. The following is slightly off-topic, but I thought of it when you mentioned your frustration with your medical records. I went to a doctor appointment with a new doctor who had never seen me. It was my goal to get him to recommend to my insurance provider to get me a standing wheelchair. As I began talking, he asked to see my stump (I lost a leg in my accident). I said, "Alright". As I raised my skirt, I mentioned, out of modesty, that I was wearing a diaper. He looked at my stump and then turned toward his computer and began typing madly. I continued with my "pitch" on why I needed a standing wheelchair. When I finished speaking, he was still typing,... apparently doing research. Then he turned around trimphant and offered me surgery, so that I wouldn't need to wear diapers. I declined his offer. As he was putting me out the door, I realized that he hadn't heard a word I'd said about the wheelchair. From the moment I"d mentioned that I was "covered" with a diaper, he apparently hadn't heard another word I'd said. My record probably says that I came seeking incontinence help. And he asked me about incontinence on my next visit, too. And no, he couldn't get me the standing wheelchair. What do you think provoked your spinal stroke?

[Sue Pendleton]

Aspirin? I have often wondered if aTP should be tried when someone presents with signs of a spinal stroke. I think my C5-7 incomplete is probably genetic.

[SCI-Nurse]

Not all spinal strokes are caused by blood clots, Sue. Some, as above, are caused by fibrocartilaginous embolism, AVM bleeds, or air embolism (such as in the bends). Others can be caused by loss of blood flow from the the artery of Adamkiewicz, also known as the great anterior radiculomedullary artery due to surgery or trauma of the aorta. None of those will be helped by aspirin or TPA; in fact bleeds will be made worse by use of the anti-coagulants.

(KLD)

[Ronnoco]

Reviewing these post a few years on, after the drama died down a bit, a couple of points seem appropriate.

Regional hospitals, even big ones, may not be able to have neurologicaL staff on your case immediately. Other medical staff who deal with more common day to day conditions try to do their best. Unfortunately key information from that a mysterious spinal stroke patient might give, can easily not be recognised or recorded. A neurologist is not always available.

Second point is that if the patient recalls something like, " after doing some back flips and the potatoe sack race, i started to get strange pains in my hips".....but the fact that young person went bungee jumping a week before might not be mentioned or had a fall from a motorbike or went on a jet ski across waves at speed for an hour. The early stage comment, "after back flips", tends to set the stage as to what the cause is and gets re written or simply copied again and again and the later addition by examiners. Unfortunate but true. Its a kind of bureaucratic malaise.

but my problems started at entry to A&E, there was a 6000 person protest outside doors of the A&E over its planned closure on the day, the reception handed me a form for a car accident report, as they had run out of other report forms, hence my injury became a car accident in official terms. It was sort of like that hitchcock or kafka movie. I knew some staff in the hospital, i had a fall but they all knew it as a car accident. I was sent to an Centre of Excellence, a regional one, away from this local one, an ortho sent me home after day 2, "nothing wrong with you son",
just slight slip of disk, you'll be ok after day or 2. The orderlies lifted me onto feet for trip home, i fell on floor, they tried a few times and eventually put me in wheelchair luckily to local hospital where local head doctor recognised the unusual condition of paralysisfrom upper chest down! Quite an achievement given that the orhopaedic surgeon became the countries head of spinal injury charity or some such later. 13 years on I am still partly paralysed.

After which i was admitted under a neurologist whom i repected . Despite his skill, the ward nurses had little training in spinal injury, leaving me more a less on my own to find a wheel chair, get into it with no core muscles on my own, find a toilet, obtain help from visitors to get to a toilet, etc. Elderly parents brought edible food.
There was no wheel chair toilet, but on old one from. 30's with a ramp, pulled myself down corridors using, borrowed walking stick on hand rail, 400 metres, broken windows and snow blowing in. I kid you not.

After 4 weeks in that dickensian
" university hospital centre of excellence", i was returned home to remote countryside by the hospital by ambulance. My ceiling had collapsed in from frozen and burst pipes while in hospital for several weeks. Minus 13c. Had to fix plumbing from wheel chair. A local plumber came and helped to get heat going. He never sent a bill.


About 2 months later, having lived alone in a wheelchair over a very cold winter, i was admitted for rehab. This hospital knew a bit about spinal injury and had a neurologist. Although it was an old one, set up around time of Florence Nightingale and the furniture and iron beds unchanged. BUT, they had a Neurologist who knew a thing or two.

The place had persons with numerous conditions, not just spinal, war veterans from balkans, amputees, basket case wards, the whole works.

But most of all, they knew about how to approach rare injuries, with limited resources, they were a lighthouse in darkness.

And for this reason, i am most thankful that a charity was estabshed to cater for the absences of state in a so called modern western country.

dont assume a hospital can safeguard your unusual condition , you need all the help you can muster to from friends and family to ensure you get not just basic treatment but full treatment. It is far from automatic.