CONCUSSION OF THE SPINAL CORD 447 



segment the symptoms will be modified somewhat owing 

 to the injury of the sacral segment which results in paralysis 

 of the area supplied by the sciatic nerve. The sphincters 

 of the bladder and anus respectively will be paralyzed and 

 urine and feces discharged involuntarily. 



When the injury occurs in small animals spasms of adja- 

 cent muscles will be observed. This is due no doubt to the 

 injury producing stimulation to the nerve roots. On 

 examination of the patient the temperature is often elevated, 

 or it may be subnormal if the sphincters are relaxed and the 

 thermometer inserted in the rectum. Palpation over the 

 region of injury will cause the animal intense pain and fre- 

 quently convulsions or spasms. Swelling is often present 

 and crepitation may be detected. Abnormal movement of 

 the vertebra; involved can be determined in the cervical and 

 lumbar segments. 



Diagnosis.— This is accomplished only after careful exam- 

 ination and consideration of the parts paralyzed. The 

 determination of the degree of injury is often very difficult. 

 There might be a complete paralysis resulting from edema 

 and hemorrhage greatly resembling cases of destruction 

 of the cord. However, the history of the case will assist in 

 the differential diagnosis. 



Course.— In complete destruction of the cord in the 

 cervical segment death may occur in a few moments or 

 may be delayed for several hours. Should there be hemor- 

 rhage only and partial paralysis the patient may live for 

 several days and some will make a complete recovery. In 

 involvement of the dorsal and lumbar segments the course 

 will depend upon the degree of injury. In small animals they 

 may live for several weeks or months. 



Prognosis.— A definite prognosis is often difficult to arrive 

 at on account of the impossibility to determine the degree 

 of injury in all cases. When there is evidence of complete 

 destruction of the cord the case is hopeless. In cases of 

 hemorrhage or edema most patients will make a complete 

 recovery. At best the prognosis should be held in reserve 

 until the exact condition can be determined. 



