- Neurogenic shock
Neurogenic shock is a distributive type of shock resulting in hypotension, occasionally with bradycardia, that is attributed to the disruption of the autonomic pathways within the spinal cord. Hypotension occurs due to decreased systemic vascular resistance resulting in pooling of blood within the extremities lacking sympathetic tone. Bradycardia results from unopposed vagal activity and has been found to be exacerbated by hypoxia and endobronchial suction. Neurogenic shock can result from severe central nervous system damage (brain injury, cervical or high thoracic spinal cord). In more simple terms: the trauma causes a sudden loss of background sympathetic stimulation to the blood vessels. This causes them to relax (vasodilation) resulting in a sudden decrease in blood pressure (secondary to a decrease in peripheral vascular resistance).
Neurogenic shock can be a potentially devastating complication, leading to organ dysfunction and death if not promptly recognized and treated. It is not to be confused with spinal shock, which is not circulatory in nature.
- Fluid is always the initial treatment of shock, especially since concomitant hemorrhagic shock must be excluded following trauma. Most institutions will additionally utilize pressor agents to achieve hemodynamic stability.
- Dopamine (Intropin) is often used either alone or in combination with other inotropic agents.
- Vasopressin (antidiuretic hormone [ADH])
- Certain vasopressors (ephedrine, norepinephrine). Phenylephrine should be avoided as it can worsen bradycardia often seen in neurogenic shock.
- Atropine (speeds up heart rate and cardiac output)
- ^ J.M. Piepmeyer, K.B. Lehmann and J.G. Lane, Cardiovascular instability following acute cervical spine trauma, Cent Nerv Syst Trauma 2 (1985), pp. 153–159.
- ^ 4. Guly HR, Bouamra O, Lecky FE. The incidence of neurogenic shock in patients with isolated spinal cord injury in the emergency department. Resuscitation (2008) 76, 57-62
- ^ "Dorlands Medical Dictionary:neurogenic shock". http://www.mercksource.com/pp/us/cns/cns_hl_dorlands_split.jsp?pg=/ppdocs/us/common/dorlands/dorland/seven/000096569.htm.
- ^ http://www.health.am/vein/more/hypotension_shock_treatment/
Symptoms and signs: circulatory (R00–R03, 785) CardiovascularTachycardia/Bradycardia · Palpitation
Heart sounds: Heart murmur (Systolic, Diastolic, Continuous) · Gallop rhythm (Third heart sound, Fourth heart sound) · Pericardial friction rub · Split S2 · Heart click
Wikimedia Foundation. 2010.
Look at other dictionaries:
neurogenic shock — shock resulting from neurogenic vasodilation, which can be produced by cerebral trauma or hemorrhage, spinal cord injury, deep general or spinal anesthesia, or toxic central nervous system depression … Medical dictionary
neurogenic shock — noun Shock caused by extreme excitability of the parasympathetic nervous system. This hyperexcitability is caused by severe pain and results in an extreme slowing of heartbeat and pulse. This leads to a dangerous drop in blood pressure and hence … Wiktionary
Shock (circulatory) — Acute shock redirects here. For the psychological condition, see Acute stress reaction. Shock ICD 10 many incl. R57 ICD 9 785 DiseasesDB … Wikipedia
Shock — In medicine, shock is a critical condition brought on by a sudden drop in blood flow through the body. There is failure of the circulatory system to maintain adequate blood flow. This sharply curtails the delivery of oxygen and nutrients to vital … Medical dictionary
shock — Synonyms and related words: AC arc, Poulsen arc, abscess, accident, ache, aching, agitate, ague, amplify, anaphylactic shock, anemia, ankylosis, anoxia, aperiodic discharge, apnea, appall, appulse, arc, arc column, arc discharge, asphyxiation,… … Moby Thesaurus
shock — n. the condition associated with circulatory collapse, when the arterial blood pressure is too low to maintain an adequate supply of blood to the tissues. The patient has a cold sweaty pallid skin, a weak rapid pulse, irregular breathing, dry… … The new mediacal dictionary
hypovolemic shock — shock resulting from insufficient blood volume for the maintenance of adequate cardiac output, blood pressure, and tissue perfusion. Without modification the term refers to absolute hypovolemic shock caused by acute hemorrhage or excessive fluid… … Medical dictionary
Distributive shock — is defined by hypotension and generalized tissular hypoxia. This form of relative hypovolemia is the result of blood vessel dilation. Septic shock is the major cause, but there are other examples as well. Examples Examples of this form of… … Wikipedia
shell shock — Synonyms and related words: accident neurosis, anaphylactic shock, anxiety hysteria, anxiety neurosis, association neurosis, battle fatigue, blast neurosis, combat fatigue, compensation neurosis, compulsion neurosis, conversion hysteria,… … Moby Thesaurus
Шок (Shock) — реакция организма на воздействие чрезвычайных раздражителей, характеризующаяся развитием у человека тяжелых расстройств кровообращения, дыхания, обмена веществ (ред.). Артериальное давление резко снижается, кожа больного покрывается холодным… … Медицинские термины