dive buddies who volunteer to participate in the study by permittingdata collection during dives they previously arranged.Interventions: Core temperature is collected by ingesting a small,FDA-approved “pill” thermometer called the CorTemp® probeprior to diving.Main Outcome Measures: Core temperature analysis is col-lected after dives with a receiver and data will be statisticallyanalyzed at a later date.Results: Preliminary data has shown a C7 ASIA A tetraplegic had acore body temperature decrement of approximately 3.04 degreesCelsius during a 60-minute dive in training pool with an averagetemperature of 27.7 degrees Celsius. An able-bodied diver withsimilar body habitus had a core body temperature decrement of only0.8 degrees Celsius in the same conditions for the same duration.Conclusions: Divers with SCI are more susceptible to hypother-mia while participating in diving than their able-bodied counter-parts. Special considerations must be taken to ensure maintenanceof safe core body temperature in divers with SCI. Further studiesmay identify the efficacy of measures to conserve body heat in diverswith SCI. It is our hope that the study results will help lead toestablished guidelines for safe adaptive diving.

Poster 494Impact of Race on Functional Outcome FollowingSpinal Cord Injury.Junney M. Baeza Dager, MD (University of Miami- Jack-son Memorial Hospital, Miami, FL, United States); DianaD. Cardenas, MD, MHA; Kevin L. Dalal, MD; Lina M.Hurtado, MD; Douglas Johnson-Greene, PHD.

Disclosures: J. M. Baeza Dager, No Disclosures.Objective: 1.To compare the functional outcome as a measuredby the Functional Independence Measure (FIM) score, betweendifferent ethnic groups (ie, Caucasian, African American and His-panic) who sustained a spinal cord injury (SCI) and were admittedto an inpatient rehabilitation spinal cord injury unit. 2. To deter-mine the impact of race concordance between the therapists andpatients on functional outcomes.Design: Retrospective design using information submitted to theUniform Data System for Medical Rehabilitation (UDSMR) and achart review of all SCI consecutive admission during FY 2008-09.Setting: Jackson Memorial Hospital, Miami-Florida.Results: Of all SCI admissions, 30% (44) were Caucasian, 26%(38) were African American, 33% (48) were Hispanic and 11% (10)others. No statistical differences were found in FIM gain or FIMefficiency (ie, FIM points divided by hospital days) between thethree groups. The three races showed an average FIM gain and FIMgain of 23 during their hospital admission. Therapy concordancewas present for 55% (80) of the patients. No statistical differenceswere found in FIM gain and FIM efficiency for those who hadtherapy concordance compared to those without therapy concor-dance.Conclusions: This study examined the potential impact of race intwo ways, functional improvement and therapy concordance. Usingthe FIM as an objective rating system to measure outcomes amongSCI patients no significant differences were found for ethnicity.However the impact in the healthcare disparities should be studiedin the future.

Poster 495Diagnosing Mild Brain Injury in Patients WithTraumatic Spinal Cord Injury.Kathryn Sigford, MD (Stanford University, Stanford, CA,United States); Kathleen Castillo, MA, CCC-SLP, BRS-S;Kazuko Shem, MD.

Disclosures: K. Sigford, No Disclosures.Objective: To evaluate the cognitive deficits of mild traumaticbrain injury (TBI) in individuals with spinal cord injury (SCI) whowere admitted to an acute inpatient rehabilitation program and whopresented with signs and symptoms consistent with TBI.Design: Retrospective study.Setting: Acute inpatient rehabilitation facility (IRF).Participants: 12 subjects with traumatic SCI.Interventions: We administered the Repeatable Battery for theAssessment of Neuropsychological Status (RBANS) to patients withSCI admitted to the IRF and suspected of having a TBI. Demo-graphic data was also collected.Main Outcome Measures: RBANS total and subscale scores.Results: Twelve subjects (2 female, 10 male) with traumatic SCIwere enrolled in this study. Average age was 39.8 years old(SD�14.9). Etiology of injury was sports related (42%), vehicleaccidents (33%), and falls (25%). Days from injury to the RBANSexamination was 13.3 days (SD�7.6). Eight subjects had cervicalinjury and 4 subjects had paraplegia. The subjects’ average scoreswere as follows: immediate memory (41 percentile), visuospatial/construction (36 percentile), language (25 percentile), attention(12.5 percentile), delayed memory (51 percentile), and total score(22 percentile). Three subjects were unable to participate in visu-ospatial/construction, attention, and delayed memory subscales astheir injuries precluded use of their hands to complete the writtenportions of these subscales.Conclusions: Individuals with traumatic SCI who were sus-pected to have sustained a head injury showed significant cognitivedeficits on the RBANS testing, especially in the language and atten-tion contents. Further studies are needed to assess incidence, riskfactors, and consequences of TBI in this patient population. Inaddition, a fully oral neuropsychological test would be beneficial tofurther study in this area as many patients with SCI are unable tocomplete written tasks.

Poster 496Phlegmasia Alba Dolens: A Rare Presentation ofDeep Vein Thrombosis in Spinal Cord Injury: ACase Report.Kelly Williams, DO (Thomas Jefferson University Hospi-tal, Philadelphia, PA, United States); Christopher S. For-mal, MD.

Disclosures: K. Williams, No Disclosures.Case Description: Patient: A 48-year-old man with T11 ASIA Cparaplegia. The patient developed acute onset painful, cold, pallor-ous, and edematous lower limb 4 weeks post injury. He had aninferior vena cava filter placed after his injury and had been receiv-ing prophylactic heparin.Setting: Free-standing acute rehabilitation hospital.Results or Clinical Course: Doppler ultrasound performed atnearby emergency room was positive for large proximal deep veinthrombosis (DVT). This atypical presentation was consistent withphlegmasia alba dolens (PAD), a rare form of DVT. The patient was

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started on therapeutic enoxaparin as a bridge to warfarin therapyand returned to acute rehabilitation with an uncomplicated course.Discussion: The typical presentation of DVT involves acute onsetpain, warmth, erythema, and swelling of the involved limb. PAD isa rare presentation of DVT that typically results from massivethrombus in the proximal limb circulation, resulting in compro-mised venous outfow. PAD is the term to describe evolution of theclot to include collateral veins, causing severe vascular congestionand fluid sequestration. Because of its presentation, PAD is oftenconfused for arterial occlusion, and even compartment syndrome. Itholds a 25% mortality rate, 25-50% pulmonary embolism rate, andup to a 50% amputation risk due to its potential for progression togangrenous limb.Conclusions: PAD is a rare and life-threatening presentation ofDVT. Because the qualities of its presentation are often contrary tothe typical signs of DVT, it may be difficult to recognize, thereforeprolonging diagnosis and necessary treatment. Although it is mostcommonly associated with malignancy, late pregnancy, and otherhypercoaguable states, it should also be considered in the spinalcord injury population when evaluating a painful limb that does notpossess typical signs of DVT.

Poster 497Weightlifting Resulting in Multiple Acute CervicalDisk Herniations and Tetraplegic Spinal Cord Injury(SCI): A Case Report.Lailah C. Issac, DO (Sinai Hospital of Baltimore, Balti-more, MD, United States); Henry S. York, MD.

Disclosures: L. C. Issac, No Disclosures.Case Description: The patient is a 25-year-old right-handedman. While weightlifting, he felt a pinch in his neck and left armnumbness as he performed a standing press. He developed progres-sive weakness in his legs and distal arms over 2 hours. Acutehospital evaluation revealed a complete tetraplegic spinal cordinjury (SCI) without sacral sparing. Imaging showed severe fifth,sixth, and seventh cervical vertebral level (C5- C7) central diskherniation, canal space narrowing, and anterior cord indentation.He underwent anterior C5-C7 discectomy and fusion. Examinationon admission to comprehensive SCI rehabilitation showed a C7American Spinal Injury Association Impairment Scale (AIS) B in-complete SCI, with new light touch sensation in his right lowestdermatome. Repeat MRI showed cervical edema reduction butpersistent spinal canal stenosis, for which he was transferred toneurosurgery for a C4 through first thoracic (T1) vertebral levelposterior decompression and fusion.Setting: Freestanding rehabilitation hospital.Results or Clinical Course: Neurological examination on read-mission to rehabilitation was relatively unchanged. After an addi-tional 6 weeks of rehabilitation, his examination improved to C7AIS C, with trace bilateral hip flexion, knee extension, and right toeextension. He was able to perform upper body dressing and wheel-chair propulsion on level surfaces independently, but requiredmoderate assistance for lower body activities of daily living andtransfers. He was transferred to another acute rehabilitation facilityto continue therapies.Discussion: Although lumbar disk herniation from spinal flexionis commonly associated with weightlifting, there are no reports ofacute cervical disk herniation resulting from participation in thissport. This case illustrates the potential for weightlifting to result in

tetraplegic SCI, the importance of careful neurological examination,and the functional improvement that can result from rehabilitation.Conclusions: Athletes, coaches, and clinicians should be awarethat disk herniation and tetraplegic SCI can result from weightlift-ing.

Poster 498A Unique Presentation of Acute Non-GallstonePancreatitis Following Traumatic Cervical SpinalCord Injury: A Case Report.Larisa Gaitour, DO (NYU Medical Center, New York, NY,United States); Jung Hwan Ahn, MD; William Kim, MS IV.

Disclosures: L. Gaitour, No Disclosures.Case Description: The patient is a 56-year-old man with nosignificant past medical history but schizoaffective disorder, whofell from a rooftop resulting in a fracture of the C7 with cervical SCI.He underwent C7 laminectomy and C5-T2 fusion at outside hospi-tal. Upon arrival to our facility his neurologic status was noted to be“motor level of C6”, and “sensory level of T2” placing him inCategory A of ASIA classification. On the 11th day post injury,patient complained of nausea. Pt had no vomiting and no abdominalpain. Physical examination revealed distended abdomen with hypo-active bowel sounds. He looked uncomfortable.Program Description: A 56-year-old man with traumatic spinalcord injury (SCI) admitted for acute inpatient rehabilitation.Setting: Acute rehabilitation hospital.Results or Clinical Course: Blood was drawn for serum lipaseand amylase which were significanty elevated. Liver function testswere borderline high. Ultrasound revealed normal gallbladder with-out any gallstones. CT imaging demonstrated mild edema of thepancreas compatible with Balthazar Grade B pancreatitis. The lipaseand amylase levels trended down to baseline with IV hydration andNPO for a week. His GI symptoms resolved and he was begun onlow fat diet. He had no difficulty with daily bowel regimen for hisneurogenic bowel.Discussion: There have been several case reports regarding acutepancreatitis following traumatic spinal cord injury. One retrospec-tive study revealed that the average onset time of acute pancreatitiswas 16�5.5 days after trauma. The most widely accepted hypoth-esis is that acute pancreatitis after a traumatic SCI may be caused bylocal over-stimulation of sphincter of Oddi (sphincter ampulaehepatopancreaticae) by the vagal innervation in the setting of acuteautonomic nervous system dysfunction.Conclusions: Pancreatitis can be easily overlooked in patientswith spinal cord injury because of impaired sensory feedback mech-anism. Physicians should recognize acute pancreatitis as a possiblecomplication of acute posttraumatic spinal cord injury following atrauma in order to provide proper management in a timely fashionand minimize risks of morbidity and mortality.

Poster 499Osteoporotic Humeral Fracture in ChronicTetraplegia With No Reported Trauma: A CaseReport.Lisa Wenzel, Medical Degree (Baylor College of Medi-cine, Houston, TX, United States); Jeffrey Berliner, DO.

Disclosures: L. Wenzel, No Disclosures.Case Description: A 39-year-old woman with C2 completetetraplegia 25 years post injury with ventilator dependence.

S360 PRESENTATIONS