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  4. SCREENING AND OUTCOMES OF CO-OCCURRING TRAUMATIC BRAIN INJURY AMONG PEOPLE WITH SPINAL CORD INJURY: A SCOPING REVIEW

SCREENING AND OUTCOMES OF CO-OCCURRING TRAUMATIC BRAIN INJURY AMONG PEOPLE WITH SPINAL CORD INJURY: A SCOPING REVIEW

Journal of Rehabilitation Medicine, 2025 · DOI: 10.2340/jrm.v57.41897 · Published: January 3, 2025

Spinal Cord InjuryRehabilitationBrain Injury

Simple Explanation

Traumatic brain injury, when this occurs with traumatic spinal cord injury, is often referred to as a dual diagnosis. Dual diagnosis, while often missed, is common and rates vary associated with difficulties consistently identifying the traumatic brain injury, especially when the focus is on the traumatic spinal cord injury. Impacts of co-occurring traumatic brain injury appear greater relative to spinal cord injury alone but only a few studies analysed outcomes based on traumatic brain injury severity.

Study Duration
Not specified
Participants
Twenty-five studies were included
Evidence Level
Scoping Review

Key Findings

  • 1
    Screening under-estimated traumatic brain injury incidence when approaches relied on inconsistently collected traumatic brain injury indicators, especially for mild traumatic brain injury.
  • 2
    Although mixed, outcomes among persons with moderate to severe co-occurring traumatic brain injury especially, appeared poorer than those with spinal cord injury alone.
  • 3
    Impacts of co-occurring traumatic brain injury appear greater relative to SCI alone but few studies analysed outcomes based on traumatic brain injury severity.

Research Summary

The biggest challenges for capturing co-occurring TBI appear related to reliance on retrospective clinical records hampered by incomplete and inconsistent documentation of TBI indicators. Impacts of co-occurring TBI on tSCI rehabilitation outcomes, while mixed, tended to be larger with greater severity of TBI. Accurate identification of co-occurring TBI in the clinical setting is highly dependent on consistent documentation of TBI indicators from acute to rehabilitation contexts.

Practical Implications

Improve Screening

Multivariable approaches to traumatic brain injury ascertainment and greater consistency in documenting acute traumatic brain injury indicators may improve reliability.

Address TBI Severity

Further studies are needed to analyze outcomes based on traumatic brain injury severity.

Consider Sub-Acute Rehabilitation

Considering diagnosis of concomitant TBI in the sub-acute rehabilitation phase may be more effective.

Study Limitations

  • 1
    Limited geographical diversity may affect the global generalizability of findings
  • 2
    Changes in diagnostic criteria, treatment approaches, and rehabilitation strategies over time
  • 3
    Heterogeneity in study designs can make it challenging to bring findings together

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