Presentation
Consequently, neurogenic shock's unique presentation includes: [5] [6] Neurogenic shock is diagnosed based on a person's symptoms and blood pressure levels. [en.wikipedia.org]
Therefore, awareness of and knowledge about the occurrence, clinical presentation and treatment are essential. [rba.elsevier.es]
Entire Body System
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Hypothermia
[…] inotropic support with dopamine or norepinephrine is required; this should be reserved for patients who have decreased urinary output despite adequate fluid resuscitation; usually, low doses of dopamine in the 2- to 5-mcg/kg/min range are sufficient Prevent hypothermia [medscape.com]
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Internal Bleeding
It can also help doctors to detect any internal bleeding or additional damage. MRI scan An MRI scan is an imaging test used to show internal structures of your body, such as your spine. [healthline.com]
Respiratoric
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Labored Breathing
Symptoms of neurogenic shock include sweaty, cool skin; labored breathing, low blood pressure; dizziness; and anxiety. Many people with neurogenic shock have suffered an injury to the nervous system, such as the spinal cord. [en.wikipedia.org]
Gastrointestinal
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Nausea
Adverse reactions, such as nausea and vomiting, may occur after treatment initiation, but these can be controlled by concomitant use of an antiemetic agent. [ncbi.nlm.nih.gov]
Cardiovascular
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Hypotension
Signs and symptoms [ edit ] Instantaneous hypotension due to sudden, massive vasodilation Warm, flushed skin due to vasodilation and inability to constrict blood vessels. [en.wikipedia.org]
Orthostatic hypotension and autonomic pathways after spinal cord injury. J Neurotrauma. 2006 Dec. 23(12):1713-25. [Medline]. Brown CV, Antevil JL, Sise MJ, Sack DI. [medscape.com]
Skin
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Flushing
Signs and symptoms [ edit ] Instantaneous hypotension due to sudden, massive vasodilation Warm, flushed skin due to vasodilation and inability to constrict blood vessels. [en.wikipedia.org]
Neurologic
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Headache
Side effects were infrequent; only one patient complained of transient headaches. Neither hyponatremia nor serum electrolyte abnormalities occurred. [tandfonline.com]
On admission, in the emergency department, she presented with vomit, headache and somnolence (Glasgow Coma Scale (GCS) of 14) and her CT scan showed a triventricular hydrocephalus ( Fig. 1 ). [rba.elsevier.es]
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Cognitive Impairment
impairment, whereas darifenacin was not [75]. [urotoday.com]
Lackner TE, Wyman JF, McCarthy TC et al: Randomized, placebo-controlled trial of the cognitive effect, safety, and tolerability of oral extended-release oxybutynin in cognitively impaired nursing home residents with urge urinary incontinence. [auanet.org]
Workup
Clinical Principle Urodynamics, cystoscopy and diagnostic renal and bladder ultrasound should not be used in the initial workup of the uncomplicated patient. [auanet.org]
Treatment
Treatment [ edit ] Dopamine (Intropin) is often used either alone or in combination with other inotropic agents. Vasopressin (antidiuretic hormone [ADH]) [7] Certain vasopressors ( ephedrine, norepinephrine ). [en.wikipedia.org]
Once occult sources of hemorrhage have been excluded, initial treatment of neurogenic shock focuses on fluid resuscitation. Judicious fluid replacement with isotonic crystalloid solution to a maximum of 2 L is the initial treatment of choice. [medscape.com]
Prognosis
Cardiovascular prognosis of “masked hypertension” detected by blood pressure self-measurement in elderly treated hypertensive patients. JAMA. 2004 ; 291 : 1342–1349. [ahajournals.org]
[…] advocated in the treatment of NPE include fosfodiesterase inhibitors, beta1-antagonists alone or in combination with a vasodilator, and alfa-antagonists. 1,14 The pure form of NPE may resolve within 48–72 h with adequate treatment. 1,3,5 The patients prognosis [rba.elsevier.es]
Etiology
[…] years of various surgical technics directed toward alleviation of essential, or idiopathic, hypertension has renewed interest in the role of the sympathetic nervous system and its splanchnic divisions in regulation of blood pressure and their possible etiologic [jamanetwork.com]
[…] neurologic insult and the exclusion of other possible causes. 4 The most common causes of NPE are subarachnoid hemorrhages, followed by head trauma, seizures, embolic stroke, neurologic endovascular procedures and increased intracranial pressure (ICP) of any etiology [rba.elsevier.es]
Intravesical oxybutynin has also been evaluated in limited studies involving detrusor overactivity of neurologic etiology [78]. Its use, however, requires catheterization and can be cumbersome. [urotoday.com]
Acquired stuttering can be further classified in psychogenic or neurogenic stuttering according to its etiology. [neurologia.com]
Epidemiology
Epidemiology of traumatic spinal cord injury. Kirshblum S, Campagnolo DI, DeLisa JA, eds. Spinal Cord Medicine. Baltimore, Md: Lippincott Williams & Wilkins; 2002. 69-81. Go BK, DeVivo MJ, Richards JS. The epidemiology of spinal cord injury. [medscape.com]
To assemble new insights regarding the epidemiology, pathophysiology, diagnosis, evaluation and treatment of neurogenic stuttering. DEVELOPMENT. [neurologia.com]
Choo MS, Ku JH, Lee JB et al: Cross-cultural differences for adapting overactive bladder symptoms: results of an epidemiologic survey in Korea. World J Uro 2007; 25 : 505. 8. [auanet.org]
“Epidemiology and healthcare utilization of neurogenic bladder patients in a US claims database.” Neurourol Urodyn 30(3): 395-401. Metz, L. M., S. D. McGuinness, et al. (1998). “Urinary tract infections may trigger relapse in multiple sclerosis.” [urotoday.com]
Pathophysiology
Neurogenic shock results from damage to the spinal cord above the level of the 6th thoracic vertebra. [4] It is found in about half of people who suffer spinal cord injury within the first 24 hours, and usually doesn't go away for one to three weeks. [4] Pathophysiology [en.wikipedia.org]
Pathophysiology The underlying pathophysiologic mechanism is not yet fully understood. To this uncertainty contributes the fact that neurogenic stuttering can occur associated with multiple pathologies and multiple lesion sites. [neurologia.com]
Prevention
Treatment options are meant to stabilize you and prevent any additional injury or damage. First, your doctor will immobilize you to prevent further damage. Then they will give you fluids intravenously to regulate your blood pressure. [healthline.com]
If intubation and mechanical ventilation is needed, it should be performed using a technique which will avoid increase of either ICP or systemic arterial pressure yet maintain cerebral perfusion. 1 Ventilation with supplemental oxygen should prevent hypoxemia [rba.elsevier.es]
[…] inotropic support with dopamine or norepinephrine is required; this should be reserved for patients who have decreased urinary output despite adequate fluid resuscitation; usually, low doses of dopamine in the 2- to 5-mcg/kg/min range are sufficient Prevent [medscape.com]
Urinary tract infections in patients with spinal cord lesions: Treatment and prevention. Drugs 2001;61: 1275-87. 5. García Leoni ME, Esclarín De Ruz A. Management of urinary tract infection in patients with spinal cord injuries. [jscisociety.com]
In the bladder, OnaBoNT-A acts at the presynaptic cholinergic junction where it prevents the release of acetylcholine from the presynaptic nerve terminal. This prevents stimulation of the detrusor muscle. [urotoday.com]