Previous studies of trauma related spinal cord injury patients (SCI) suggest that nearly 50% of these patients sustain a concomitant closed head injury (CHI). Early reports suggest that some of these patients demonstrate cognitive deficits within the first year after injury. However, these studies are hampered by several problems, including the lack of controls and the inability to administer screening tests requiring hand function to this population. This study will evaluate neuropsychological deficits in newly injured spinal cord injury patients and relate this to the incidence and severity of medical complications at one year after injury. Prevalence Study: The incidence and duration of loss of consciousness and traumatic amnesia will be evaluated in newly injured spinal cord injury patients. These patients will undergo a standard battery of neuropsychological testing, which is predominantly motor free, to evaluate deficits in orientation, memory, abstract reasoning and problem solving. A control group matched for age, sex, level of education and geographic location will be utilized to develop mental performance ranges on these tests. Premorbid information regarding other factors which may be related to cognitive dysfunction will also be assessed. This study will test the hypothesis that the majority of patients with evidence of cognitive dysfunction have sustained a concurrent CHI. Medical Morbidity: All patients will be reviewed at one year following discharge from initial rehabilitative care to determine the incidence and severity of medical morbidities associated with SCI. It is expected that patients with associated cognitive dysfunction are at greater risk for the development of medical complications during this one year period. Such findings might warrant modification of patient education or length of stay during initial hospitalization as well as the frequency and form of outpatient follow-up for these patients.
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