Factor VII: Cost-Effective Solution For Severe Hemorrhage In Trauma

Factor VII (Seven) is a protein produced by humans that will stop bleeding by making the blood clot. Factor VII is produced by the pharmaceutical industry into ‘recombinant activated factor VII’ which is a much under utilized medication that likely represents a life-saving treatment for those with catastrophic injuries and medical conditions causing uncontrolled bleeding. […]

Severe Intracranial Pressure Treatment: Off With The Skull!

The primary goal in the acute management of severe traumatic brain injury (TBI) is to prevent secondary brain damage caused by a sharp rise of intracranial pressure (ICP). Trauma related etiologies of increased ICP include hemorrhagic contusions, epidural hematomas, subdural hematomas, and diffuse axonal injury. Approximately 10-15% of patients who have suffered a severe TBI […]

Quadriplegics: Aspiration- When Is The Fiberoptic Exam?

Approximately 40% of quadriplegics admitted to acute rehabilitation hospitals have impairments in swallowing referred to as dysphagia. Dysphagia places them at risk of developing aspiration pneumonia, which is a dangerous pneumonia caused by bacteria in the mouth that pass into the lungs with aspirated saliva, liquids, or solid food particles. Aspiration refers to passage of […]

Hip Fractures in Children: Serious Complications

Hip fractures in children are very rare and generally the result of high- speed motor vehicle accidents. Approximately one third of these fractures historically would result in serious complications including avascular necrosis (AVN) and coxa vara deformity both of which results in progressive pain, leg length discrepancy, and disability. Treatment of a displaced hip fracture […]

Spinal Cord Injured Women: We Need To Talk About Sex Dr. Greg Vigna, MD, JD

Spinal cord injury (SCI) has a significant impact on the emotional and physical components that contribute to sexuality. Sexuality is a complex concept that allows humans to care for another and be loved, it allows us to be excited, and in essence be physically connected to another. Very few studies have been conducted on this […]

Vertebral Artery Dissection: Lifetime Treatment Required

Traumatic vertebral artery injuries occur in up to twenty percent of hospitalized patients with traumatic brain injuries and up to seventy percent of those who suffer cervical spinal fractures. It is more common in high cervical spine fractures (C1, C2, or C3) and fractures above C6 that involve a subluxation, which involves a shift of […]

Dislocation of the Knee: Diverse Injuries, Diverse Outcomes

Over half of all knee dislocations are the result of high-speed motor vehicle accidents and are associated with multiple injuries in approximately 30% of cases. A knee dislocation is an obvious diagnosis when the knee is still dislocated but in up to 15% of cases there may be a spontaneous reduction back into place, which […]

Neurological Consequences of Dural Sealants: Cauda Equina Syndrome

Cerebral spinal fluid (CSF) leaks are a complication of spinal surgery that is the result of accidental tears or cuts through the dura mater that serves as a watertight tissue layer that functions to prevent the CSF from leaking out of the central nervous system. This complication is nearly unavoidable and occurs in approximately fourteen […]

Spinal Cord Injured, “Will I Ever Urinate Again?”

“Will he ever walk again?” This is inevitably the first question I am asked by family members outside the hospital room of a newly injured spinal cord patient. For a variety of reasons the injured will not ask the significance of my neurological exam as it pertains to prognosis early during their hospitalization. It is […]

Vena Cava Filters in Traumatic Injury Patients: Still Useful Despite Their Faults

Greg Vigna, MD, JD, an academic rehabilitation physician serving a Level 1 Trauma Center in Indianapolis states, “Removable Inferior Vena Cava Filters (IVC) that are placed in traumatic brain injury, spinal cord injury and complex pelvic fracture patients are rarely removed within the FDA recommended time frame. The FDA states these filters should be removed […]