SCI from position of your neck?

[TINAMARIE]

Is it possible to get an SCI from lying in one position for too long (14 hours)? My neurologist says you can, but my physiatrist says you can't!

[SCI-Nurse]

I am unclear what the mechanism or cause of getting a SCI from prolonged immobilization like this would be. If this were the case, people who are in prolonged surgeries, deep sleepers, or astronauts would be in deep trouble. I will ask Dr. Young his experience or knowledge about this as well.

(KLD)

[Wise Young]

Tinamarie, what an interesting question! What prompted it? My first reaction is the same as KLD's. Of course, parts of your body that are under pressure for such a long time may become damaged but your spinal cord should be protected from such pressures. Wise.

[TINAMARIE]

I'm asking because we aren't positive what caused my SCI...I overdosed on prescription drugs and when I was found 14 hours later, I was laying with my neck in a very awkward position. The paramedics didn't put me in a neck brace because they didn't suspect a SCI. When my exhusband arrived at the emergency room he said I was on the gurney there with my neck at a 90 degree angle...even AFTER they had pumped my stomach. Until I awoke the next day and informed them I was paralyzed, they assumed I could not move because of the pills I had taken. Once I told them I was paralyzed they finally did an MRI and saw that it was a SCI and immediately transferred me to another hospital. The neurologists there told me the SCI was either from my neck being in such an awkward position for so long or from my blood pressure dropping too low from the meds. Once I got to rehab at U of M, my dr there said it couldn't be from the position of my neck, it was because my blood pressure had dropped so low. He sais my blood pressure would had have to have been as low as 30 over palpable to cause this. It's not that I don't believe my physiatrist, but there are just so many questions thatI have about it...I just want to know for sure what happened to me.

[SCI-Nurse]

Certainly a very low blood pressure could conceivable cause what is called a "watershed" stroke of the spinal cord, although with a blood pressure that low it is also common that this would occur in the brain as well. Generally if this is the case, a particular pattern of tissue damage would be seen in the MRI that is consistent with the tissues supplied by specific blood vessels such as the anterior spinal artery. These seems to be a much more likely scenario than than immobilization causing spinal cord damage.

In elderly people with spinal stenosis and athrosclerosis, there have been reported cases of stroke with extreme movements of the neck. This has been associated with shampoos in salons where you must bend your neck back into extreme extension. These have been more associated with brainstem strokes than with spinal cord strokes though. Here are a couple of citations on this:
Beauty parlor stroke syndrome (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12023594&dopt=Abstract)

Salon sink radiculopathy (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10418846&dopt=Abstract)

I also have seen two cases of spinal cord infarction from chiropractic manipulation.

(KLD)

[This message was edited by SCI-Nurse on 05-19-04 at 11:25 AM.]

[TINAMARIE]

KLD,

I've been thinking about what you said about it being common that this would occur in the brain, also. I am not sure if any MRI's were ever done on my brain. I can't remember everything, but no one ever mentioned my brain. They were concerned about the paralysis. I have noticed, and mentioned to several people, that my memory is not as good as it was before. The psychologist at U of M did a brief psychological test and found that my ability to recall words was not quite as good as she expected it to be, although still in the "average" range. (I have always been "above average" in everything) It has been 9 months now and things aren't getting any better. Recently I have noticed they are a little worse. Now this is nothing that someone else would notice to talk to me, but it is very annoying to me!! In your opinion would it do me any good to ask my neurologist for an MRI if I haven't had one? Is there anything I can do to get back to where I was before this happened?