[Forum Ninja]

Orthostatic hypotension following spinal cord injury: understanding clinical pathophysiology

Abstract

Motor and sensory deficits are well-known consequences of spinal cord injury (SCI). During the last decade, a significant number of experimental and clinical studies have focused on the investigation of autonomic dysfunction and cardiovascular control following SCI. Numerous clinical reports have suggested that unstable blood pressure control in individuals with SCI could be responsible for their increased cardiovascular mortality. The aim of this review is to outline the incidence and pathophysiological mechanisms underlying the orthostatic hypotension that commonly occurs following SCI. We describe the clinical abnormalities of blood pressure control following SCI, with particular emphasis upon orthostatic hypotension. Possible mechanisms underlying orthostatic hypotension in SCI, such as changes in sympathetic activity, altered baroreflex function, the lack of skeletal muscle pumping activity, cardiovascular deconditioning and altered salt and water balance will be discussed. Possible alterations in cerebral autoregulation following SCI, and the impact of these changes upon cerebral perfusion are also examined. Finally, the management of orthostatic hypotension will be considered.

Full pdf below.

Attached File(s)

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[mttb14]

Thanks for posting this abstract onto the forum, I have just downloaded it to send to our Barrister.

It might help explain a few things to him about the blinding headache over John's eyes, he had it for more than 5 days, and it was very soon after his injury. The GP who was next to useless, he just put it down to tension headaches, we even phoned the out of hours ambulance service, John was told to take pain killers. When it was probably spinal shock causing the problems.

It later transpired that his spinal cord was flattened at C5/6 by the discs, so he has an incomplete spinal cord injury.

Thanks again,

Maria.