Autonomic Dysreflexia – a Serious Complication of Spinal Cord Injury

Authors: J. Kříž 1;  M. Rejchrt 2
Authors‘ workplace: 2. LF UK a FN v Motole, Praha Spinální jednotka při Klinice rehabilitace a tělovýchovného lékařství 1;  2. LF UK a FN v Motole, Praha Urologická klinika 2
Published in: Cesk Slov Neurol N 2014; 77/110(2): 168-173
Category: Review Article


Autonomic dysreflexia is a serious complication found in more than half of patients with spinal cord injury above the T6 level. In case of an autonomic system disorder, a trigger below the level of injury causes severe vasoconstriction with paroxysmal hypertension. Presenting symptoms include bradycardia, pounding headache, sweating and flushing above the level of lesion, and anxiety. However, AD can sometimes occur without symptoms. The causes of AD include bladder and bowel distension, urological surgeries as well as burning, pressure sores and fractures. Uncontrolled hypertension can lead to hemorrhagic stroke, retinal he­morrhage, respiratory or cardiac problems and even death. Management involves placing the patient in an upright position to take advantage of orthostatic reduction in blood pressure. As the first line of treatment, the cause of irritation has to immediately be eliminated; this usually leads to blood pressure stabilization. If hypertension continues, rapid onset antihypertensive drugs should be used.

Key words:
spinal cord injury – autonomic dysreflexia – tetraplegia

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manu­script met the ICMJE “uniform requirements” for biomedical papers.


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