B.L., age 17 has a compression fracture at C5 to C6, a result of diving from a bridge into a river and hitting a submerged rock. Fortunately, a companion who had first aid training as a lifeguard rescued her and tried to minimize any secondary damage. In the emergency department, B.L. could not move her limbs or sense touch and lacked reflexes in her limbs or sense touch and lacked reflexes in her limbs.
Surgery was performed to relieve pressure and stabilize the fracture site.
Several weeks later, routine examination indicated that some spinal cord reflexes were returning in the lower extremities. Gradually more reflexes returned. Some muscle tone and movement of the shoulder and upper arm became apparent, but no other function returned.
One day, B.L. suddenly developed a severe headache and blurred vision. Her blood pressure was 210/120 mm Hg, and her pulse was 62 beats per minute.
- Explain what has probably caused this effect and what action needs to be taken?
- Suggest the four specific components for a rehabilitation programme for B.L. Expand your comments on an area of particular concern to you.
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