Brain and Spine Trauma

UT Southwestern Medical Center offers patients the focused, expert care needed to maximize the chance of full recovery of function and independence after a traumatic injury.   

The multidisciplinary team at UT Southwestern is a leader in brain trauma research to pioneer new treatments, and we have one of the nation’s premier treatment centers for brain and spine trauma. 

Effective Care for Maximum Recovery

Brain and spine injuries are often the result of falls, motor vehicle accidents, and sports-related injuries. Some injuries might be the result of internal conditions, such as infection, inflammation, tumors, bleeding, or problems such as strokes or aneurysms. 

Physicians at UT Southwestern have the experience and expertise to treat a range of brain and spine injuries. Our multidisciplinary team includes physicians and nurses who are specialists in brain and spinal cord injuries; they work closely with physical, speech, and occupational therapists; rehabilitation psychologists; and social workers.

Preventing Brain and Spine Trauma

Prevention of brain and spine trauma involves safe practices and protective measures:

• Wear a helmet when playing sports and while riding a bicycle, motorcycle, skateboard, or all-terrain vehicle.
  
• Drive safely. Car crashes are one of the most common causes of head and spinal cord injuries. Wear a seat belt as a driver or passenger and don’t drink and drive (or text and drive).
  
• Check water depth before diving. Do not dive into a body of water unless it is at least 9 feet deep. Store firearms, unloaded, in a locked safe. Store bullets in a separate location.
  
• Get rid of clutter to prevent falls. 

Brain Trauma

UT Southwestern offers unparalleled treatment for traumatic brain injury (TBI) and other neurological trauma. As part of the North Texas Traumatic Brain Injury Center, UT Southwestern partners with trauma centers at Parkland Hospital, JPS Hospital, and Baylor University Medical Center to provide outstanding clinical care and cutting-edge TBI research.

Diagnosis and Treatment

To diagnose a brain injury and determine its severity, we will conduct a physical examination and use other diagnostic tests such as CT or MRI scans of the brain. 

Concussion or mild TBI causes temporary dysfunction of brain cells and requires rest for a full recovery. After their evaluation, patients can usually recover at home, requiring only rest, activities and exercises that are modified based on diagnosis, over-the-counter pain relievers, and close monitoring. If symptoms persist or get worse, or if new symptoms develop, specialized management might be needed. 

Moderate to severe TBI requires emergency care. These TBIs can cause bruising, torn tissues, and bleeding in the brain. The trauma team at UT Southwestern will work to stabilize these patients and minimize secondary damage due to bleeding, inflammation, or reduced oxygen supply to the brain. 

Medications can help limit secondary damage to the brain. These can include:

• Diuretics: Given intravenously to people with TBI, diuretics help reduce pressure inside the brain by decreasing fluid in tissues and increasing urine output.
  
• Anti-seizure drugs: Doctors might prescribe these medications during the first week to avoid any additional brain damage that might be caused by a seizure.
  
• Coma-inducing drugs: These medications put people into temporary comas because a comatose brain needs less oxygen to function. A medically induced coma can be helpful if blood vessels, compressed by increased pressure in the brain, are unable to deliver the usual amount of nutrients and oxygen to brain cells. 

Emergency surgery might be needed to minimize additional damage to brain tissues. Surgery can be used to:

• Remove clotted blood (hematomas): Bleeding outside or within the brain can result in a collection of clotted blood that puts pressure on the brain and damages brain tissues.
  
• Repair skull fractures.
  
• Relieve pressure inside the skull: Draining accumulated cerebral spinal fluid or creating a window in the skull can provide more room for swollen tissues. 

For critically ill patients with brain injuries and neurological diseases, the hospital’s Neurological Intensive Care Unit (neuro ICU) provides state-of-the-art monitoring technology and innovative treatments from physicians trained in neurology, neurosurgery, and critical care.

Rehabilitation

Patients with significant brain injury will require rehabilitation. They might need to relearn basic skills such as walking or talking. 

Our Brain Injury Rehabilitation Program is located in Zale Lipshy University Hospital, where a dedicated and highly trained team helps patients improve their ability to function at home and in the community. Patients have on-site access to neurological rehabilitation and all medical, surgical, and imaging specialists. 

Our rehabilitation team helps patients with TBI achieve their highest possible level of physical, functional, and cognitive independence, with the goal of returning home to their families and community support systems. Our ultimate aim is to help our patients get back to work, school, and other daily activities. 

Clinical Trials and Research

Patients at UT Southwestern also benefit from access to clinical trials and research at the Texas Institute for Brain Injury and Repair, a comprehensive initiative that is transforming how brain injuries are prevented and treated. The goal of this unique collaboration is to bring together technology advances, innovative research, and best practices in patient care to enhance the treatment and diagnosis of brain injuries.

Spine Trauma

UT Southwestern has years of expertise in treatment and rehabilitation of people who have experienced spine injuries. Treatments and rehabilitation help many people lead productive and independent lives. 

Conditions and Diagnosis

Spine injuries result from damage to the spinal cord, vertebrae, ligaments, or disks of the spinal column.

Additional damage can occur due to bleeding, swelling, inflammation, and fluid accumulation in and around the spinal cord. Spine damage can cause permanent changes in strength, sensation, and other body functions. 

To diagnose a spine injury, our specialists will typically conduct a physical examination that includes testing sensory function and movements. They will also use diagnostic tests such as X-rays, computed tomography (CT), and MRI scans. 

Treatment

Moderate to severe spine injuries require emergency care. Because the body often responds with shock, initial treatment goals include managing blood pressure and heart function.

Secondly, the goal is to stabilize the patient, immobilize head and spine movements, and minimize secondary damage. This care usually requires stabilization surgery and the use of removable braces for safety. We work to prevent blood clots and make sure that our patients remain free of lung and other infections. 

Spine Injury Rehabilitation

For patients with complex spine injuries and surgery, the rehabilitation goal is to help the patient with strengthening, safe mobilization (getting up and down and walking), and the ability to manage self-care. 

For those with spinal cord injury (nerve injury), a wider array of therapies might be needed. UT Southwestern’s Inpatient Rehabilitation team is skilled in helping each patient achieve the highest possible level of independence. Because spinal cord injuries can affect almost every aspect of a person’s life, our expertise includes personalized, comprehensive approaches to help patients adapt to their condition, adjust to daily activities, and gain increased levels of function and independence. 

For many patients, rehabilitation for spinal cord injuries begins with a carefully coordinated transition from our intensive care unit (ICU) to the rehabilitation program, where occupational and physical therapists begin a program tailored specifically to the patient’s needs. Along with physicians who are specialists in spinal cord injuries, the rehabilitation team includes nurses, neuropsychologists, psychologists, and social workers.  

In addition to exercise and other forms of therapy, our team uses weight-supported treadmill training external robotics for ambulation and mobility training. For affected arms and hands, we might use specific types of electrical stimulation and splinting. We help our patients and families engage with the community again, whether by walking or using a wheelchair.

Our medical staff offers a wide variety of services to family members as well as patients, including psychological counseling, support groups, and educational programs that can address all questions about spinal cord injuries and rehabilitation.