Session Title: Virtual Poster Hall
Session Time: None. Available on demand.
Disclosures: Lauren E. Massey, MD: No financial relationships or conflicts of interest
Case Description: We present the case of a previously healthy 38-year-old uninsured Spanish-speaking woman involved in a motor vehicle collision that resulted incomplete C4 AIS C tetraplegia due to atlanto-occipital dissociation with associated cervical Spinal Cord Injury (SCI), severe Traumatic Brain Injury (TBI) who was also found to be 12 weeks pregnant. Medical care significant for spine fusion and tracheostomy for respiratory insufficiency. For dysphagia, a nasogastric tube was used for nutrition as patient was not a candidate for PEG tube placement due to pregnancy. Maternal-fetal medicine consulted for the high-risk pregnancy. On rehab admission, patient demonstrated issues with incomplete spastic tetraplegia, impaired cognition and multiple secondary medical complications along with vital pregnancy. Her psychosocial status remained complicated due to lack of US citizenship but positively,resources were available to allow for inpatient rehabilitation.
Setting: Inpatient Rehabilitation Hospital
Patient: A 38-year-old pregnant woman with dual diagnosis of incomplete SCI and severe TBI Assessment/
Results: With a comprehensive rehabilitation approach, this patient progressed from AIS C to AIS D classification for her SCI and from Rancho level VI to VIII for her TBI classification as seen from admission to discharge. Using intensive rehabilitation strategies, she increased her oral intake with no need for feeding tube and moved toward tracheostomy decannulation. After rehabilitation, patient will be able to safely discharge home with assistance from family and continue her pregnancy safely despite her new dual-diagnosis of injuries.
Discussion: This is the first reported case, to our knowledge, of a newly diagnosed pregnant woman with a dual diagnosis SCI/TBI discharging home from inpatient rehabilitation.
Conclusion: Acute inpatient interdisciplinary rehabilitation strategies provide the optimal setting for successful rehabilitation for dual-diagnosis TBI and SCI and can improve the likelihood of a favorable pregnancy outcome for new dual diagnosis pregnant women.
Level of Evidence: Level V
To cite this abstract in AMA style:Massey LE, Jones M. Approach to Interdisciplinary Rehabilitation of Pregnant Woman with Dual Diagnosis of Traumatic Spinal Cord Injury and Brain Injury with Incomplete Tetraplegia: A Case Report [abstract]. PM R. 2020; 12(S1)(suppl 1). https://pmrjabstracts.org/abstract/approach-to-interdisciplinary-rehabilitation-of-pregnant-woman-with-dual-diagnosis-of-traumatic-spinal-cord-injury-and-brain-injury-with-incomplete-tetraplegia-a-case-report/. Accessed July 30, 2021.
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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/approach-to-interdisciplinary-rehabilitation-of-pregnant-woman-with-dual-diagnosis-of-traumatic-spinal-cord-injury-and-brain-injury-with-incomplete-tetraplegia-a-case-report/