8012 - Hematomyelia

DBQ: Link to Index of DBQ/Exams by Disability for DC 8012 

Definition

Hematomyelia is defined as hemorrhage of blood into the substance of the spinal cord.

Etiology

The condition may result from trauma, vascular malformation, vasculitis, bleeding disorders, or tumors.

Signs & Symptoms

The signs and symptoms demonstrated are determined by the spinal level of the lesion and include back pain, and/or arm and leg weakness, numbness and inability to control urine and bowel elimination.

Tests

Lumbar puncture should be avoided due to the risk of deterioration. Magnetic resonance imaging (MRI) demonstrates the extent of the bleeding. Examinations appropriate to the underlying cause may be done.

Treatment

Initially, clotting disorders are treated and reversed, and then emergency surgery for decompression of the spinal cord may be required as soon as possible.

Residuals

Substantial recovery may follow surgery, especially if some motor function was present preoperatively. However, permanent deficits are usually present.

Special Considerations

  • May be entitled to special monthly compensation where the Veteran has a single service-connected disability rated as 100% with additional service-connected disability or disabilities independently ratable at 60% or more, which are separate and distinct from the 100% service-connected disability and involves different anatomical segments or bodily systems. See  38 CFR 3.350(i)(1) – Special Monthly Compensation (SMC)

Notes

  • Minimum rating of 10%.

  • It is required for the minimum ratings for residuals under diagnostic codes 8000-8025, that there be ascertainable residuals. Determinations as to the presence of residuals not capable of objective verification, i.e., headaches, dizziness, fatigability, must be approached on the basis of the diagnosis recorded; subjective residuals will be accepted when consistent with the disease and not more likely attributable to other disease or no disease. It is of exceptional importance that when ratings in excess of the prescribed minimum ratings are assigned, the diagnostic codes utilized as bases of evaluation be cited, in addition to the codes identifying the diagnoses.

  • Disability in this field is ordinarily to be rated in proportion to the impairment of motor, sensory or mental function. Consider especially psychotic manifestations, complete or partial loss of use of one or more extremities, speech disturbances, impairment of vision, disturbances of gait, tremors, visceral manifestations, injury to the skull, etc. In rating disability from the conditions in the preceding sentence refer to the appropriate schedule. In rating peripheral nerve injuries and their residuals, attention should be given to the site and character of the injury, the relative impairment in motor function, trophic changes, or sensory disturbances.  38 CFR 4.120

  • With the exceptions noted, disability from the following diseases and their residuals may be rated from 10 percent to 100 percent in proportion to the impairment of motor, sensory, or mental function. Consider especially psychotic manifestations, complete or partial loss of use of one or more extremities, speech disturbances, impairment of vision, disturbances of gait, tremors, visceral manifestations, etc., referring to the appropriate bodily system of the schedule. With partial loss of use of one or more extremities from neurological lesions, rate by comparison with the mild, moderate, severe, or complete paralysis of peripheral nerves” 38 CFR 4.124a