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01 December 2004

Autonomic dysreflexia manifested by severe hypertension

Farahnak Assadi, Kimberly Czech, Julie L. Palmisano

Med Sci Monit 2004; 10(12): CS77-79 :: ID: 13237


Background:Autonomic dysreflexia (AD) is a sudden and exaggerated autonomic response to stimuli in patients with spinal cord injuries or dysfunction above the splanchnic sympathetic outflow (T5-T6). Hypertension is a relatively common manifestation of AD.Case Report:We describe a case of a young man with T4-T6 spinal cord tumor who developed severe hypertension before any other clinical feature of AD, leading to a subsequent clinical evaluation and the correct diagnosis. Treatment with labetalol was only partially successful in controlling the elevated blood pressure. Hypertension resolved immediately after bladder decompression.Conclusions:AD manifested by severe hypertension is uncommon. Bladder decompression appears to be safe and effective for management of hypertension in patients with AD.

Keywords: Autonomic Dysreflexia - diagnosis, Autonomic Dysreflexia - etiology, Labetalol - therapeutic use, Antihypertensive Agents - therapeutic use, Autonomic Dysreflexia - etiology, Blood Pressure - physiology, Drainage, Hypertension - therapy, Labetalol - therapeutic use, Spinal Neoplasms - complications, Urinary Bladder, Neurogenic - physiopathology

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750