Headache attributed to autonomic dysreflexia: an underrecognized clinical entity.
1Department of Medicine, Division of Neurology, and Lyndhurst Centre, Toronto Rehabilitation Institute, University of Toronto, Toronto, Canada. jcfurlan@gmail.com
Neurology
|August 24, 2011
Summary
Headache attributed to autonomic dysreflexia (AD) after spinal cord injury (SCI) presents with sudden, severe head pain and vital sign changes. Increased clinician awareness is crucial for prompt recognition and management of AD headaches.
Area of Science:
- Neurology
- Spinal Cord Injury Medicine
- Autonomic Nervous System Disorders
Background:
- Headache attributed to autonomic dysreflexia (AD) following spinal cord injury (SCI) presents significant diagnostic and management challenges.
- Understanding the specific features of AD-related headaches is essential for effective clinical practice.
Purpose of the Study:
- To systematically review the literature and delineate the characteristic features of headaches associated with autonomic dysreflexia in individuals with SCI.
Main Methods:
- A comprehensive literature search was conducted across multiple databases (MEDLINE, CINAHL, EMBASE, PsycINFO) for English-language articles published from 1950 to April 2010.
- Included articles addressed any aspect of headache attributed to autonomic dysreflexia after SCI.
- A total of 45 articles met the inclusion and exclusion criteria from an initial pool of 273 publications.
Main Results:
- The typical headache attributed to AD after SCI is characterized by sudden onset and severe intensity.
- Accompanying symptoms frequently include hypertension, altered heart rate, and diaphoresis above the SCI level.
- Various stimuli, both noxious and non-noxious, can trigger these headaches, necessitating awareness of diverse triggers.
Conclusions:
- Enhanced awareness of headaches attributed to autonomic dysreflexia among clinicians, especially neurologists, is vital.
- Early recognition and appropriate management are critical to prevent potential complications associated with AD episodes.
- Further understanding of this clinical entity can improve patient outcomes following spinal cord injury.
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