Nutritional management of a patient with brain damage and spinal cord injury.

Few reports on nutritional management of patients with both brain damage and spinal-cord-injury appear in the literature. We present a case of a 20-year-old male quadriplegic, C4 complete, who also sustained brain damage secondary to cerebral anoxia. When the patient was transferred to our rehabilitation unit, deterioration in nutritional status was noted, as evidenced by weight loss and depressed serum albumin and hemoglobin. Nutritional rehabilitation consisted of weaning from nasogastric tube feedings to an oral diet providing snacks and commercial supplements. This resulted in a positive nitrogen balance. Other factors, such as mobilization, exercises, and closure of a pressure sore, contributed favorably to improvement of nutritional status.