Neurogenic shock is a life-threatening condition in which your circulatory system becomes upset and causes a sudden drop in blood pressure due to spinal cord injury (SCI). It is a dangerous condition in which blood pressure drops suddenly and may cause irreversible damage to your body cells. If left untreated, may cause irreversible damage. Spinal cord injury occurs mostly below the level of T6.
This injury may occur due to traumatic injury to the spinal cord due to multiple reasons such as accidents or some other diseases. This disrupting type of shock is characterized by a loss of an autonomic reflex. This dysregulation of autonomic tone is due to a loss of sympathetic tone and an unopposed parasympathetic response. It refers to the hemodynamic triad of hypothermia, hypotension, and peripheral vasodilation. These symptoms need immediate intervention and treat promptly.
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What Causes Neurogenic Shock?
Neurogenic shock often occurs due to injury or trauma to the spinal cord. This damage to the spinal cord disrupts the sympathetic nervous system of your body. The sympathetic nervous system controls your physical activities such as high blood pressure, strengthening of heart rate, maintenance of the airway tract, and strength of vocal cords. Loss of this sympathetic nervous system results in loss of your physical activities, a drop in blood pressure, and a decrease in the efficiency of heart-pumping activity.
The main causes of spinal cord injury may include:
Automobile or car accidents that may cause central nervous system damage or spinal cord injury
- sport injuries
- gunshot wounds to the spine
- improper administration of anesthesia to the spinal cord.
- Disc herniation
- Others diseases such as osteoporosis and osteoarthritis etc
- Falling from height
- A violent attack
- Diving into the shallow water
Neurogenic shock symptoms
One of the main symptoms of neurogenic shock is to decrease blood pressure from irregular blood circulation. This irregular blood circulation can cause a number of other symptoms that may guide your health care provider regarding spinal cord injury. This may symptoms include
- Increased sweating
- blank stares
- pale skin
In severe cases, it can cause further symptoms such as
- Difficult breathing
- Chest pain
- Decrease heart rate or bradycardia
- Cyanosis of fingers and lips
- Difficulty in speech
How Neurogenic Shock Can Be Diagnosed?
In order to diagnose this condition, doctors will first perform a physical examination for additional symptoms and monitor your blood pressure. There are also a number of tests doctors use to show the severity of the injury that caused neurogenic shock
In order to find out the Neurogenic shock, your health care provider will perform lots of tests such as
- Detailed history
- Proper physical examination like monitoring of blood pressure, heart rate
- Examination of symptoms
- CT scan
- MRI scan
- Urinary catheter
These investigations will guide your doctor to find out the actual cause of Neurogenic shock.
Management of Neurogenic Shock
Neurogenic shock can cause irreversible damage to your body tissues if left untreated. Treatment is to cure or to stabilize the damaged portion of the spinal cord.
Following steps are used to treat this emergency treatment.
- Maintain airways openings and secure breathing
- Stabilize the vitals such as maintenance of blood pressure by giving intravenous fluids. If the blood pressure is too low despite fluids, then vasopressors or other medication can be given to regulate the blood pressure. The common vasopressors may include epinephrine, dopamine, dobutamine, etc.
- Provide oxygen to maintain the oxygen saturation
- Stabilization of neck by rigid neck collars and stabilization of spinal cord by the hard bed
Treatment varies from patient to patient depending on the level of spinal cord injury and the severity of the injury to the spinal cord. These measurements are to prevent further spinal damage and other complications.
How Can I Prevent The Spinal Cord Injuries?
Spinal cord injuries often occur due to unpredictable events, therefore, the best thing is to minimize the risks such as
- Always use a seatbelt while driving
- Wear proper protective gear while playing sports
- Never dive into the shallow water
- Always choose the most experienced anesthetist, if you’re going for surgery.
- If you’re having any underlying pathology, treat it as soon as possible to prevent complications.
These preventions are not to treat the Neurogenic shock but to prevent further damage to the sympathetic nervous system. Though Neurogenic shock is irreversible damage the immediate interventions can be made less dangerous.