Neurocritical Care & TBI | Management and Outcomes of Patients with Concomitant Traumatic Brain Injury and Spinal Cord Injury*
Date: October 19, 2026
Time: 3:45 pm to 5:15 pm
Room: Coral 5
Track: Traditional Special Interest Group (SIG)
Session Description
This session will examine the management of patients with concomitant traumatic brain injury (TBI) and spinal cord injury (SCI), drawing on current clinical and translational research. With co-occurrence rates as high as 30–50% in SCI and approximately 12.5% in TBI, this “dual diagnosis” presents significant challenges across the continuum of care—from neurocritical care to neurorehabilitation.
Faculty will review key management principles and clinical guidelines for both TBI and SCI, with a focus on optimizing neurological and functional recovery while minimizing secondary complications. Through an integrated care perspective, the session will highlight strategies to improve survival, recovery, and quality of life in this complex patient population.
Learning Objectives
At the conclusion of this session, attendees will be able to:
- Describe clinical practice guidelines for the management of TBI and SCI in acute and neurocritical care settings.
- Apply rehabilitation principles to patients with concomitant TBI and SCI across the continuum of care.
- Compare outcomes associated with dual diagnosis versus isolated central nervous system injury.
Speakers
- (Chair, Speaker) Julio Furlan, MD, LLB, MBA, PhD, MSc, FRCPC, FASIA
- (Co-Chair) Sherry Chou, MD, MSc, FANA
- (Speaker) Halinder Mangat, MD, MSc
- (Speaker) Maria Paulino, BS (2026 SIG Oral Presenter)
- (Speaker) Skylar Lewis, BA (2026 SIG Oral Presenter)
Management of Concomitant TBI and SCI in the Neurocritical Care Setting
Description
The simultaneous occurrence of traumatic brain injury (TBI) and spinal cord injury (SCI) presents complex diagnostic and therapeutic challenges in the neurocritical care setting. The interplay between these injuries can complicate neurological assessment, critical care management, and recovery, requiring a coordinated, multidisciplinary approach to optimize patient outcomes.
This presentation will examine the unique clinical features of patients with concomitant TBI and SCI, with a focus on diagnosis, acute management, and the challenges associated with caring for this complex patient population. Participants will review strategies for neurological evaluation, discuss evidence-based approaches to critical care management, and explore considerations related to hemodynamic support, neuroprotection, and secondary injury prevention. Topics will also include the practical challenges of balancing treatment priorities when both brain and spinal cord injuries are present and opportunities to improve outcomes through multidisciplinary care.
Attendees will leave with a greater understanding of the complexities of managing concurrent TBI and SCI and practical strategies for diagnosing and treating these patients in the neurocritical care setting using an evidence-based, patient-centered approach.
Management of Concomitant TBI and SCI in the Acute Care and Rehabilitation Settings
Description
Individuals living with concomitant traumatic brain injury (TBI) and spinal cord injury (SCI) represent a particularly complex population, requiring coordinated care that spans the continuum from acute management through rehabilitation. Advances in clinical and translational research are improving our understanding of these coexisting injuries and informing strategies to optimize neurological recovery and functional outcomes.
This presentation will review the current clinical and translational evidence guiding the management of patients with concomitant TBI and SCI in both the acute care and rehabilitation settings. The presenters will discuss the pathophysiological interactions between brain and spinal cord injury, explore evidence-based approaches to acute medical management and rehabilitation, and highlight emerging research that is shaping future therapeutic strategies. Topics will also include the importance of interdisciplinary care in addressing the cognitive, physical, and functional challenges experienced by this patient population.
Attendees will leave with a greater understanding of the evolving evidence supporting the management of concomitant TBI and SCI and practical insights into applying research findings to improve patient care, rehabilitation, and long-term neurological outcomes.
Operationalizing the Neural Exposome in Mild TBI: Feasibility and Directional Trends of a Three-Domain Framework on Cognitive Trajectories using Principal Component Analysis
Description
Cognitive trajectories following mild traumatic brain injury (mTBI) are heterogeneous, yet the factors driving differences in recovery remain poorly understood. Individuals with mTBI face an increased risk of persistent cognitive impairment and later dementia, highlighting the need for earlier identification of patients at risk for poor cognitive recovery. Although educational, environmental, psychosocial, and behavioral factors have each been linked to outcomes after TBI, these exposures are often studied individually, neglecting to capture real-world settings in which patients simultaneously accumulate burdens across multiple domains.
This presentation will examine cognitive recovery following mTBI through the framework of the neural exposome, defined as the totality of exposures that influence neurological health across the lifespan. Participants will review the National Institute of Neurological Disorders and Stroke (NINDS) neural exposome framework and explore how endogenous, exogenous, and behavioral factors may collectively contribute to post-mTBI cognitive trajectory. Using an exploratory outpatient mTBI cohort, the presentation will discuss the application of principal component analysis to characterize multidimensional exposure burden and evaluate its relationship with 6-month cognitive recovery. Topics will also include the potential role of cumulative exposure assessment in identifying patients at greater risk for poor recovery and informing future longitudinal research.
Attendees will leave with a greater understanding of the diverse factors that may shape cognitive recovery after mTBI and how the neural exposome offers a framework for studying these factors collectively. The presentation will highlight the potential for multidimensional exposure assessment to improve cognitive risk stratification and ultimately support more individualized approaches to post-mTBI follow-up and care.
Assessment of Stakeholders' Perceptions of Outcomes After Subarachnoid Hemorrhage: A Single-center Prospective Study
Description
Aneurysmal subarachnoid hemorrhage (aSAH) can result in significant disability, yet what constitutes an acceptable outcome may differ between patients and healthcare providers.
This presentation will explore differences in how neurocritical care providers and patients or their healthcare surrogates perceive functional outcomes following aSAH. Participants will review findings from a prospective study comparing acceptable levels of disability using the Modified Rankin Scale (mRS) and Glasgow Outcome Scale-Extended (GOS-E), including providers’ preferences for these commonly used outcome measures. Findings highlight potential gaps between provider and patient expectations for functional recovery.
Attendees will leave with a better understanding of these differences and their potential relevance to patient-centered communication about recovery and functional outcomes after aSAH.
