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Blood pressure and spinal cord injury

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https://www.readbyqxmd.com/read/29205090/rapamycin-exacerbates-cardiovascular-dysfunction-after-complete-high-thoracic-spinal-cord-injury
#1
Khalid C Eldahan, David H Cox, Jenna L Gollihue, Samir P Patel, Alexander G Rabchevsky
Autonomic dysreflexia (AD) is a potentially life-threatening syndrome in individuals with spinal cord injury (SCI) above the T6 spinal level that is characterized by episodic hypertension in response to noxious stimuli below the lesion. Maladaptive intraspinal plasticity is thought to contribute to the temporal development of AD, and experimental approaches that reduce such plasticity mitigate the severity of AD. The mammalian target of rapamycin (mTOR) has gained interest as a mediator of plasticity, regeneration and nociceptor hypersensitivity in the injured spinal cord...
December 5, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29200479/management-of-sub-axial-cervical-spine-injuries
#2
Gautam Zaveri, Gurdip Das
Sub-axial cervical spine injuries are commonly seen in patients with blunt trauma. They may be associated with spinal cord injury resulting in tetraplegia and severe permanent disability. Immobilization of the neck, maintenance of blood pressure and oxygenation, rapid clinical and radiological assessment of all injuries, and realignment of the spinal column are the key steps in the emergency management of these injuries. The role of intravenous methylprednisolone administration in acute spinal cord injuries remains controversial...
November 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/29176992/immunosenescence-in-persons-with-spinal-cord-injury-in-relation-to-urinary-tract-infections-a-cross-sectional-study
#3
David Pavlicek, Jörg Krebs, Simona Capossela, Alessandro Bertolo, Britta Engelhardt, Jürgen Pannek, Jivko Stoyanov
Background: Individuals with a spinal cord injury (SCI), despite specialized rehabilitation and good health care, have a reduced life expectancy. Infectious diseases, such as pneumonias, infected pressure sores and urinary tract infections (UTI) have been identified as the leading causes of mortality. We hypothesise that a premature onset of immune frailty occurs in SCI, possibly caused also by recurrent urinary tract infections.A cross sectional study was performed comparing blood and urine samples between able bodied controls (n = 84) and persons with spinal cord injury (n = 85)...
2017: Immunity & Ageing: I & A
https://www.readbyqxmd.com/read/29163185/orthostatic-intolerance-in-older-persons-etiology-and-countermeasures
#4
REVIEW
Nandu Goswami, Andrew P Blaber, Helmut Hinghofer-Szalkay, Jean-Pierre Montani
Orthostatic challenge produced by upright posture may lead to syncope if the cardiovascular system is unable to maintain adequate brain perfusion. This review outlines orthostatic intolerance related to the aging process, long-term bedrest confinement, drugs, and disease. Aging-associated illness or injury due to falls often leads to hospitalization. Older patients spend up to 83% of hospital admission lying in bed and thus the consequences of bedrest confinement such as physiological deconditioning, functional decline, and orthostatic intolerance represent a central challenge in the care of the vulnerable older population...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/29160569/reconstruction-of-bladder-function-and-prevention-of-renal-deterioration-by-means-of-end-to-side-neurorrhaphy-in-rats-with-neurogenic-bladder
#5
Yun Long Li, Jian Jun Wen, Yi Bo Wen, Xiang Fei He, Jun Wei Wu, Yan Wei Li, Zhong Jiang Han, Jin Jin Feng, Shao Hua Yan, Shou Lin Li, John Pfa Heesakkers, Wan Sheng Gao, Jian Guo Wen
AIMS: To investigate the feasibility of restoring bladder function and prevention of renal deterioration by neurorrhaphy in rats with neurogenic bladder (NB). METHODS: Forty-two rats were assigned to the end-to-side nerve coaptation group (ECG, n = 16), no nerve coaptation group (NCG, n = 16), and control group (CG, n = 10). In the ECG, the left ventral root (VR) and dorsal root (DR) of L6 and S1 were transected, and the distal stump of L6VR was sutured to the lateral face of L4VR...
November 21, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/29160147/impact-of-complete-spinal-cord-injury-on-healing-of-skin-ulcers-in-mouse-models
#6
Suneel Kumar, Martin L Yarmush, Biraja C Dash, Henry C Hsia, Francois Berthiaume
Pressure ulcers (PUs) are common debilitating complications of traumatic spinal cord injury (SCI) and tend to occur in soft tissues around bony prominences. There is, however, little known about the impact of SCI on skin wound healing due to the lack of suitable animal models for studies in controlled experimental settings. Herein we describe a reproducible and clinically relevant mouse model of PUs in the context of complete SCI. Adult male mice (BALB/c) were subjected to thoracic (T9-T10) complete SCI. Immediately after, a skin fold on the back of the mice was lifted and sandwiched between two magnetic discs held in place for 12 hours, thus creating an ischemic area that developed into a PU over the following days...
November 21, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29142811/carotid-artery-stiffness-and-development-of-hypertension-in-people-with-paraplegia-and-no-overt-cardiovascular-disease-a-7-year-follow-up-study
#7
Olga Vriz, Nicole Bertin, Arianna Ius, Emiliana Bizzarini, Eduardo Bossone, Francesco Antonini-Canterin
Objectives: The aim of this study was to compare arterial stiffness between people with paraplegia and able-bodied persons (ABPs) and to assess cardiovascular markers that may be predictive of the development of arterial hypertension in people with spinal cord injury (SCI). Setting: This study was conducted at rehabilitation Hospital, Udine (Italy). Methods: Fifty-seven patients with SCI were prospectively enrolled and compared with 88 healthy ABPs...
October 2017: Journal of Cardiovascular Echography
https://www.readbyqxmd.com/read/29141501/transient-hypertension-after-spinal-cord-injury-leads-to-cerebrovascular-endothelial-dysfunction-and-fibrosis
#8
Aaron A Phillips, Nusrat Matin, Mengyao Jia, Jordan W Squair, Aaron Monga, Mei Mu Zi Zheng, Rahul Sachdeva, Andrew Yung, Shea Hocolaski, Stacy L Elliott, Piotr Kozlowski, Anne Dorrance, Ismail Laher, Phil Ainslie, Andrei V Krassioukov
We aimed to create a clinically-relevant preclinical model of transient hypertension, and then evaluate the pathophysiological cerebrovascular processes resulting from this novel stimulus, which has recently been epidemiologically linked to cerebrovascular disease. We first developed a clinically-relevant model of transient hypertension, secondary to induced autonomic dysreflexia after spinal cord injury, and demonstrated that in both patients and rats this stimulus leads to drastic acute cerebral hyper-perfusion...
November 15, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29141498/incidence-and-natural-progression-of-neurogenic-shock-following-traumatic-spinal-cord-injury
#9
Ian A Ruiz, Jordan W Squair, Aaron A Phillips, Christine D Lukac, Dayan Huang, Patrick Oxciano, Dong Yan, Andrei V Krassioukov
Neurogenic shock, a distributive type of circulatory shock following spinal cord injury (SCI), results in profound hypotension. The consequent hemodynamic instability complicates clinical management, delays surgical intervention, and impacts neurological outcome. Moreover, the reported incidence of this condition varies significantly. Here, we establish the true incidence of neurogenic shock by comparing the most common clinical definitions used to diagnose the condition. Further, we characterize the acute progression and recovery of neurogenic shock...
November 15, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29116946/spinal-cord-injury-by-direct-damage-during-ct-guided-c7-transforaminal-epidural-steroid-injection-a-case-report
#10
Min Cheol Chang
Cervical transforaminal epidural steroid injection (TFESI) under the guidance of computed tomography (CT) can offer great anatomical resolution and precise needle placement in the axial plane. However, some complications, including blood pressure surge, allergic reactions, vasovagal syncope, and cerebral infarct, have been reported after CT-guided cervical TFESI. We report the first case of iatrogenic spinal cord injury (SCI) during a CT-guided cervical TFESI. A 67-year-old woman, upon receiving TFESI on Lt...
November 7, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/29088944/the-impact-of-blood-pressure-management-after-spinal-cord-injury-a-systematic-review-of-the-literature
#11
Yamaan S Saadeh, Brandon W Smith, Jacob R Joseph, Sohaib Y Jaffer, Martin J Buckingham, Mark E Oppenlander, Nicholas J Szerlip, Paul Park
OBJECTIVE Spinal cord injury (SCI) results in significant morbidity and mortality. Improving neurological recovery by reducing secondary injury is a major principle in the management of SCI. To minimize secondary injury, blood pressure (BP) augmentation has been advocated. The objective of this study was to review the evidence behind BP management after SCI. METHODS This systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Using the PubMed database, the authors identified studies that investigated BP management after acute SCI...
November 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/29078756/effects-of-lung-protective-mechanical-ventilation-associated-with-permissive-respiratory-acidosis-on-regional-extra-pulmonary-blood-flow-in-experimental-ards
#12
Rudolf Hering, Stefan Kreyer, Christian Putensen
BACKGROUND: Lung protective mechanical ventilation with limited peak inspiratory pressure has been shown to affect cardiac output in patients with ARDS. However, little is known about the impact of lung protective mechanical ventilation on regional perfusion, especially when associated with moderate permissive respiratory acidosis. We hypothesized that lung protective mechanical ventilation with limited peak inspiratory pressure and moderate respiratory acidosis results in an increased cardiac output but unequal distribution of blood flow to the different organs of pigs with oleic-acid induced ARDS...
October 27, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29066098/brown-s%C3%A3-quard-syndrome-and-cervical-post-traumatic-subarachnoid-hematoma
#13
Fernando Rascón-Ramírez, Josué M Avecillas-Chasín, Albert Trondin, M Javier Arredondo
Cervical Traumatic SSH are very rare in literature. They are usually caused by cardiopulmonary diseases that increase vascular pressure causing spinal vessels rupture. In thoracolumbar spine, the spinal puncture is the most common cause. The ventrolateral position is even more unusual. In traumatic brain injury (TBI), an abrupt extension-flexion movement could have caused the rupture of subarachnoid vessels. This, accompanied by the slowed blood "wash out" (probably due to the previous osteoarthrosis and spinal canal stenosis), led to the formation of an organized clot, which caused an acute spinal cord compression syndrome...
October 20, 2017: Neurocirugía
https://www.readbyqxmd.com/read/29057992/nutritional-blood-parameters-and-nutritional-risk-screening-in-patients-with-spinal-cord-injury-and-deep-pressure-ulcer-a-retrospective-chart-analysis
#14
Cristina Lussi, Angela Frotzler, Andreas Jenny, Dirk J Schaefer, Reto W Kressig, Anke Scheel-Sailer
STUDY DESIGN: Retrospective chart review. OBJECTIVES: To describe (i) the nutritional blood parameters (NBP) and the nutritional risk screening (NRS) in patients with spinal cord injury (SCI) and pressure ulcers (PU) III and IV according to the EPUAP classification, and (ii) the relationship between both NBP and NRS. SETTING: SCI acute care and rehabilitation clinic in Switzerland. METHODS: The NBPs were measured upon the admission of patients treated for PU III and IV between 11/2011 and 12/2014...
October 23, 2017: Spinal Cord
https://www.readbyqxmd.com/read/29019146/spinal-cord-injury-after-thoracic-endovascular-aortic-aneurysm-repair
#15
Hamdy Awad, Mohamed Ehab Ramadan, Hosam F El Sayed, Daniel A Tolpin, Esmerina Tili, Charles D Collard
PURPOSE: Thoracic endovascular aortic aneurysm repair (TEVAR) has become a mainstay of therapy for aneurysms and other disorders of the thoracic aorta. The purpose of this narrative review article is to summarize the current literature on the risk factors for and pathophysiology of spinal cord injury (SCI) following TEVAR, and to discuss various intraoperative monitoring and treatment strategies. SOURCE: The articles considered in this review were identified through PubMed using the following search terms: thoracic aortic aneurysm, TEVAR, paralysis+TEVAR, risk factors+TEVAR, spinal cord ischemia+TEVAR, neuromonitoring+thoracic aortic aneurysm, spinal drain, cerebrospinal fluid drainage, treatment of spinal cord ischemia...
December 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28973505/posterior-reversible-encephalopathic-syndrome-in-the-setting-of-induced-elevated-mean-arterial-pressure-in-patients-with-spinal-cord-injury
#16
Alexander C Whiting, Manuel P Fanarjian, Randall J Hlubek, Jakub Godzik, U Kumar Kakarla, Nicholas Theodore
BACKGROUND AND IMPORTANCE: Acute spinal cord injury (SCI) is managed by avoiding hypotension and elevating mean arterial pressure (MAP) to attain optimal perfusion of the spinal cord. Few studies have been published regarding complications related to this treatment paradigm. CLINICAL PRESENTATION: Three patients with SCI developed posterior reversible encephalopathic syndrome (PRES) during treatment with intravenous fluids and vasopressors administered to maintain elevated MAPs...
July 22, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28967294/an-autonomic-neuroprosthesis-noninvasive-electrical-spinal-cord-stimulation-restores-autonomic-cardiovascular-function-in-individuals-with-spinal-cord-injury
#17
Aaron A Phillips, Jordan W Squair, Dimitry G Sayenko, V Reggie Edgerton, Yury Gerasimenko, Andrei V Krassioukov
Despite autonomic dysfunction after spinal cord injury (SCI) being the major cause of death and a top health priority, the clinical management options for these conditions are limited to drugs with delayed onset and nonpharmacological interventions with equivocal effectiveness. We tested the capacity of electrical stimulation, applied transcutaneously over the spinal cord, to manage autonomic dysfunction in the form of orthostatic hypotension after SCI. We assessed beat-by-beat blood pressure (BP), stroke volume, and cardiac contractility (dP/dt; Finometer), as well as cerebral blood flow (transcranial Doppler) in 5 individuals with motor-complete SCI (4 cervical, 1 thoracic) during an orthostatic challenge with and without transcutaneous electrical stimulation applied at the TVII level...
November 21, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28922957/spinal-meninges-and-their-role-in-spinal-cord-injury-a-neuroanatomical-review
#18
Lukas Grassner, Andreas Grillhösl, Christoph J Griessenauer, Claudius Thomé, Volker Bühren, Martin Strowitzki, Peter A Winkler
Current recommendations support early surgical decompression and blood pressure augmentation after traumatic spinal cord injury (SCI). Elevated intraspinal pressure (ISP), however, has probably been underestimated in the pathophysiology of SCI. Recent studies provide some evidence that ISP measurements and durotomy may be beneficial for individuals suffering from SCI. Compression of the spinal cord against the meninges in SCI patients causes a "compartment-like" syndrome. In such cases, intentional durotomy with augmentative duroplasty to reduce ISP and improve spinal cord perfusion pressure (SCPP) may be indicated...
October 27, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28921013/spinal-cord-injury-as-a-complication-of-thoracic-endovascular-aneurysm-repair
#19
REVIEW
Taijiro Sueda, Shinya Takahashi
OBJECTIVE: Spinal cord ischemia (SCI) is a devastating complication of thoracic aortic aneurysm repair in the era of thoracic endovascular aneurysm repair (TEVAR). This review aims to clarify the causes of SCI during TEVAR and to propose ways that it may be prevented. METHODS AND RESULTS: We performed an extensive literature search of SCI during TEVAR. Based on the existing literature, we examined the anatomy of the anterior spinal cord artery, which supplies blood to the anterior aspect of the spinal cord, and discuss reported effective ways to prevent SCI during TEVAR, including augmentation of arterial blood pressure and drainage of cerebrospinal fluid...
September 18, 2017: Surgery Today
https://www.readbyqxmd.com/read/28895577/a-study-of-predictors-for-hyponatraemia-in-patients-with-cervical-spinal-cord-injury
#20
P W Song, F L Dong, C C Feng, Y N Shen, Y Wang, R J Zhang, P Ge, C L Shen
STUDY DESIGN: A retrospective study. OBJECTIVES: The objectives of the study were to investigate the predictors for hyponatraemia in patients with cervical spinal cord injuries (CSCIs) and to define the relationship between magnetic resonance imaging (MRI) scans and hyponatraemia. SETTING: The study was carried out at The First Affiliated Hospital of Anhui Medical University. METHODS: A total of 292 patients with CSCIs were retrospectively reviewed to determine the predictors of hyponatraemia...
September 12, 2017: Spinal Cord
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