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Thread: Spinal Stroke Diagnosis-What treatment is Reasonable

  1. #1
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    Spinal Stroke Diagnosis-What treatment is Reasonable

    Hi All

    I have had a spinal stroke and am anxious to know what typical treatment is applied once a diagnosis is made.

    What drugs would typically be administered after diagnosis?

    Is there a drug which reduces spinal swelling and limits damage thereafter?

    Are blood thinners recommended if the diagnosis is a spinal stroke.

    My injury was misdiagnosed as a spondiolysthesis and I was sent home from a main hospital to a local hospital with instructions that I would be ok in a day or two. The local hospital rejected this and sent me to a Neuro department which eventually made a spinal stroke diagnosis but there was a long delay of week between both events.

    Any comments would be welcome

    Many Thanks

    Oconnor

  2. #2
    I have asked Dr. Young to respond to your question when he has the chance.

    In my experience, those with spinal stroke are often very difficult to diagnose, and often diagnosis is delayed. Generally there are no protocols for this, and treatments for swelling, etc. that are used in traumatic SCI are not used.

    What is your level of injury, and how complete is your lesion? Are you getting rehabilitation now?

    (KLD)

  3. #3
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    Greeting Nurse and KLD


    My injury was at three levels, T8, T4/T5 then T11/12, partial lesions I understand. I was paralysed from the belly button down lasting several months with good function now on left leg, right leg has poor muscle strength in glutes, hamstrings and calf muscles, spasticity and Brown Sequard Syndrome, impaired bowel and bladder.

    My concern is whether or not some essential medication would normally be administered to a spinal stroke patient once that condition is established. By essential, I mean is there a specific medicine that should always be administered.

    More generally, I am trying to establish if there are certain critical and obvious treatments that must be applied in the case of a spinal stroke. The hospital I was admitted into was in crisis at the time, with nursing staff unable to get to work because of heavy snow for weeks on end. During that time, it was clear that the hospital was in deep crisis, large queues existed in the corridors of people with broken bone on stretchers. Shortly after that, the hospital was closed for safety reasons. So really there is great question as to what should have been done. It was rather like a battlefield hospital with patients left to fend for themselves with familiy on how best to deal with the injury. My question is really if there are specific critical drugs that should be administered once a diagnosis is made. Secondly, if the diagnosis is delayed due to a failing by the hospital in the scale of a three week period to make daignosis, is that really going to change the outcome of a spinal stroke?

    I am hoping to avoid getting involved in a medical negligence case as the Insurance Company may seek to argue that my injury would not have been so severe if the hospital had not been in crisis.

    I don't receive rehab now, 3.5 years on. I am walking outside with the aid of a stick and trying to establish the NeXT approcah to take in terms of rehab.

    Many Thanks

    O Connor.

  4. #4
    Super Moderator Sue Pendleton's Avatar
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    I suffered a spinal stroke while living in Germany in 1992 and was given the same amount of methylprednisolone as the new trauma cases were getting. They were able to start the bolus around the 8 to 10 hour mark post stroke while I was in an induced coma. They had ruled out trauma by xray and GBS by EMG I believe. At that point they had narrowed it down to acute TM, stroke or one of many rare diseases based on my husband's and our friends travel to many places in the Middle East and Africa. I believe they had already decided to try MPSS in acute TM so my resident argued it couldn't hurt long term more than a possible tracheostomy 10 days later if I didn't start breathing on my own. I was extubated on day 8. I still can't walk. An ischemic spinal stroke was confirmed about day 10 when I could be sent by ambulance to the nearest clinic with an MRI. The hospital in Augsburg was new and their MRI wasn't due to arrive for another couple months.

    I doubt there is a case for malpractice. Today if they could diagnose an ischemic stroke within a few hours tPA might help but there is no background to indicate this. Here in the US the use of methylprednisolone is up to the surgeon or ER protocols for each hospital. You might benefit now from Fampyra or Ampyra.
    Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying, "I will try again tomorrow."

    Disclaimer: Answers, suggestions, and/or comments do not constitute medical advice expressed or implied and are based solely on my experiences as a SCI patient. Please consult your attending physician for medical advise and treatment. In the event of a medical emergency please call 911.

  5. #5
    If there is a possible suit involved, I would strongly encourage you to avoid discussing the case on the internet on public forums like this. I sure your attorney would say the same thing.

    (KLD)

  6. #6
    Super Moderator Sue Pendleton's Avatar
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    The standards for malpractice are also different in most of Europe. This would truly be a case against not only the hospital but also the jurisdiction that left it open not an individual doctor. Spinal strokes not after arterial surgery or an epidural are incredible rare so most are not diagnosed very rapidly. Even with surgeries now the odds are one tenth of one percent in arterial repair cases that are planned.
    Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying, "I will try again tomorrow."

    Disclaimer: Answers, suggestions, and/or comments do not constitute medical advice expressed or implied and are based solely on my experiences as a SCI patient. Please consult your attending physician for medical advise and treatment. In the event of a medical emergency please call 911.

  7. #7
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    Hello KLD
    Thanks for advice which I will take heed of.

    Thanks Sue for recommendations and information.

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