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[Cardiovascular disorders in paraplegic patients]
1Schweizerisches Paraplegikerzentrum, Universitätsklinik Balgrist, Zürich. cavigell@balgrist.unizh.ch
Schweizerische Medizinische Wochenschrift
|July 14, 2000
Summary
Spinal cord injury above the fifth thoracic segment disrupts central autonomic nervous system control, leading to autonomic dysreflexia. This condition can cause severe cardiovascular reactions and impact daily functions, often going unrecognized.
Area of Science:
- Neuroscience
- Physiology
Context:
- Spinal cord injury (SCI) above the T5 segment disrupts central nervous system (CNS) control over the autonomic nervous system (ANS).
- Autonomic dysreflexia (AD) is a potentially life-threatening condition resulting from this loss of central regulation.
- The sensorimotor deficits of SCI are well-known, but autonomic dysfunction is often overlooked.
Purpose:
- To highlight the pathophysiology and clinical consequences of autonomic dysreflexia following high spinal cord injury.
- To emphasize the underrecognized nature of autonomic dysreflexia in SCI patients.
- To explain the mechanisms of cardiovascular, thermoregulatory, and visceral dysfunction in SCI.
Summary:
- SCI above the T5 level severs CNS connections with the sympathetic and parasympathetic nervous systems below the lesion.
- The isolated spinal cord below the injury level can initiate exaggerated autonomic responses, particularly cardiovascular.
- This leads to autonomic dysreflexia, characterized by severe hypertension, and affects thermoregulation, gastrointestinal, and genitourinary functions.
Impact:
- Increased awareness of autonomic dysreflexia in SCI management.
- Improved quality of life for individuals with SCI through better management of autonomic complications.
- Reduced morbidity and mortality associated with unrecognized autonomic dysreflexia.