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Autonomic dysreflexia

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https://www.readbyqxmd.com/read/29650001/prediction-of-autonomic-dysreflexia-during-urodynamics-a-prospective-cohort-study
#1
Matthias Walter, Stephanie C Knüpfer, Jacquelyn J Cragg, Lorenz Leitner, Marc P Schneider, Ulrich Mehnert, Andrei V Krassioukov, Martin Schubert, Armin Curt, Thomas M Kessler
BACKGROUND: Autonomic dysreflexia is a severe and potentially life-threatening condition in patients with spinal cord injury, as it can lead to myocardial ischemia, brain hemorrhage, or even death. Urodynamic investigation is the gold standard to assess neurogenic lower urinary tract dysfunction due to spinal cord injury and reveal crucial pathological findings, such as neurogenic detrusor overactivity. However, neurogenic detrusor overactivity and urodynamic investigation are known to be leading triggers of autonomic dysreflexia...
April 13, 2018: BMC Medicine
https://www.readbyqxmd.com/read/29644100/persistent-urine-leakage-around-a-suprapubic-catheter-the-experience-of-a-person-with-chronic-tetraplegia
#2
Subramanian Vaidyanathan, Jerry Ward, Bakul M Soni, Peter Hughes, Tun Oo
Introduction: Persistent urine leakage after suprapubic cystostomy in tetraplegic subjects occurs due to shrinkage of the urinary bladder and bladder spasms. The patient's social life is adversely affected as clothes become wet, smelly, and require frequent changing, thus increasing the workload of carers. Case presentation: A 48-year-old male sustained C-4 complete (AIS:A) tetraplegia while swimming in 2007. Suprapubic cystostomy was performed in 2009. From 2012, this patient had urine leakage around the suprapubic catheter, which became progressively more frequent...
2018: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/29610439/soluble-tnf%C3%AE-signaling-within-the-spinal-cord-contributes-to-the-development-of-autonomic-dysreflexia-and-ensuing-vascular-and-immune-dysfunction-after-spinal-cord-injury
#3
Eugene Mironets, Patrick Osei-Owusu, Valerie Bracchi-Ricard, Roman Fischer, Elizabeth A Owens, Jerome Ricard, Di Wu, Tatiana Saltos, Eileen Collyer, Shaoping Hou, John R Bethea, Veronica J Tom
Cardiovascular disease and susceptibility to infection are leading causes of morbidity and mortality for individuals with spinal cord injury (SCI). A major contributor to these is autonomic dysreflexia (AD), an amplified reaction of the autonomic nervous system (hallmarked by severe hypertension) in response to sensory stimuli below the injury. Maladaptive plasticity of the spinal sympathetic reflex circuit below the SCI results in AD intensification over time. Mechanisms underlying this maladaptive plasticity are poorly understood, restricting the identification of treatments...
April 2, 2018: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/29563843/fatal-cerebral-hemorrhage-in-a-tetraplegic-patient-due-to-autonomic-dysreflexia-triggered-by-delay-in-emptying-urinary-bladder-after-unsuccessful-intermittent-catheterization-by-carer-lessons-learned
#4
Subramanian Vaidyanathan, Bakulesh M Soni, Peter L Hughes, Tun Oo
Introduction: Over-distension of urinary bladder in a high spinal cord injury patient is a triggering factor for autonomic dysreflexia. Removing triggering factors is vital to prevent autonomic dysreflexia. Case presentation: A 36-year-old tetraplegic patient, who was managed by intermittent catheterizations performed by caregivers, developed recurrent autonomic dysreflexia during a week due to: 1) carers not performing intermittent catheterizations every night; 2) infrequent catheterizations during the day, leading to distension of urinary bladder...
2018: International Medical Case Reports Journal
https://www.readbyqxmd.com/read/29515212/positive-airway-pressure-therapy-for-sleep-disordered-breathing-confers-short-term-benefits-to-patients-with-spinal-cord-injury-despite-widely-ranging-patterns-of-use
#5
Jeanette P Brown, Kristy A Bauman, Armando Kurili, Gianna M Rodriguez, Anthony E Chiodo, Robert G Sitrin, Helena M Schotland
STUDY DESIGN: Prospective, cohort study. OBJECTIVES: To evaluate the effectiveness of bi-level positive airway pressure (PAP) therapy and the patterns of use for sleep-disordered breathing (SDB) in individuals with spinal cord injury (SCI). SETTING: Academic tertiary care center, USA. METHODS: Overall, 91 adults with C1-T6 SCI for ≥3 months were recruited and 74 remained in the study to be evaluated for SDB and follow-up...
March 7, 2018: Spinal Cord
https://www.readbyqxmd.com/read/29485358/the-knowledge-about-autonomic-dysreflexia-among-nursing-and-physiotherapy-students
#6
Nada Strčić, Dean Markić
CONTEXT/OBJECTIVE: Autonomic dysreflexia is a clinical syndrome affecting persons with spinal cord lesions. The aim of the study was to detect the level of knowledge among students about autonomic dysreflexia in persons with spinal cord lesions. DESIGN: Single centre questionnaire study. SETTING: Faculty of Health Studies, Rijeka, Croatia. PARTICIPANTS: Nursing (n = 43) and physiotherapy (n = 48) students. OUTCOME MEASURES: AD knowledge test...
February 27, 2018: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/29424661/preventive-care-among-primary-care-patients-living-with-spinal-cord-injury
#7
Aisha Lofters, Maha Chaudhry, Morgan Slater, Andree Schuler, James Milligan, Joseph Lee, Sara J T Guilcher
OBJECTIVE: Context/Objective: Family physicians may lack the knowledge or resources to adequately support patients with spinal cord injury (SCI). Our objectives were to determine patterns of preventive care for patients with SCI in a primary care setting (i.e. cancer screening, influenza vaccinations, general physicals, bone mineral density tests), and determine physicians' level of comfort with providing primary care to patients with SCI. DESIGN: i) Retrospective chart review, ii) Survey of physicians in the family practice...
February 9, 2018: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/29259348/cold-pressor-test-in-spinal-cord-injury-revisited
#8
REVIEW
Michèle Hubli, Doris Bolt, Andrei V Krassioukov
STUDY DESIGN: Systematic review. OBJECTIVES: A spinal cord injury (SCI) commonly results in alterations of cardiovascular physiology. In order to investigate such alterations, the cold pressor test (CPT) has been used as an established challenge test. This review summarizes the basic physiology underlying a CPT, discusses potential mechanisms responsible for abnormal pressor responses following SCI, and highlights the utility of CPT in the SCI population. SETTING: Canada and Switzerland...
December 20, 2017: Spinal Cord
https://www.readbyqxmd.com/read/29239268/a-community-perspective-on-bowel-management-and-quality-of-life-after-spinal-cord-injury-the-influence-of-autonomic-dysreflexia
#9
Jessica A Inskip, Vera-Ellen M Lucci, Maureen S McGrath, Rhonda Willms, Victoria E Claydon
Autonomic dysfunction is common in individuals with spinal cord injury (SCI) and leads to numerous abnormalities, including profound cardiovascular and bowel dysfunction. In those with high-level lesions, bowel management is a common trigger for autonomic dysreflexia (AD; hypertension provoked by sensory stimuli below the injury level). Improving bowel care is integral for enhancing quality of life (QoL). We aimed to describe the relationships between bowel care, AD, and QoL in individuals with SCI. We performed an online community survey of individuals with SCI...
February 9, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29226126/prevalence-of-autonomic-dysreflexia-in-patients-with-spinal-cord-injury-above-t6
#10
Eun Sun Lee, Min Cheol Joo
Objective: To investigate the prevalence of autonomic dysreflexia (AD) using ambulatory blood pressure monitoring (ABPM) and the autonomic dysfunction following spinal cord injury (ADFSCI) questionnaire in patients with spinal cord injury (SCI) above T6. Methods: Twenty-eight patients diagnosed with SCI above T6 were enrolled. ABPM and ADFSCI were utilized to assess AD. Using ABPM, systolic blood pressure (SBP), diastolic blood pressure, and heart rate (HR) were measured at 30-minute intervals...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29205090/rapamycin-exacerbates-cardiovascular-dysfunction-after-complete-high-thoracic-spinal-cord-injury
#11
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/29160143/some-autonomic-deficits-of-acute-or-chronic-cervical-spinal-contusion-reversed-by-interim-brainstem-stimulation
#12
Alberto A Vitores, Stephanie S Sloley, Catalina Martinez, Melissa M Carballosa-Gautam, Ian D Hentall
Prolonged electrical stimulation of the hindbrain's nucleus raphe magnus (NRM) or of its major midbrain input region, the periaqueductal gray (PAG), was previously found in rats to promote recovery from sensory-motor and histological deficits of acute thoracic spinal cord injury (SCI). Here, some visceral deficits of acute and chronic midline cervical (C5) contusion are similarly examined. Cranially implanted wireless stimulators delivered intermittent 8 Hz, 30-70 μA cathodal pulse trains to a brainstem microelectrode...
February 1, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29141501/transient-hypertension-after-spinal-cord-injury-leads-to-cerebrovascular-endothelial-dysfunction-and-fibrosis
#13
Aaron A Phillips, Nusrat Matin, Mengyao Jia, Jordan W Squair, Aaron Monga, Mei Mu Zi Zheng, Rahul Sachdeva, Andrew Yung, Shea Hocaloski, Stacy Elliott, Piotr Kozlowski, Anne M Dorrance, Ismail Laher, Philip N Ainslie, Andrei V Krassioukov
We aimed to create a clinically relevant pre-clinical 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 hyperperfusion...
February 1, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29138603/fatal-collapse-due-to-autonomic-dysreflexia-during-manual-self-evacuation-of-bowel-in-a-tetraplegic-patient-living-alone-lessons-to-learn
#14
Subramanian Vaidyanathan, Bakul M Soni, Paul Mansour, Tun Oo
Background: To identify areas for improvement, the National Health Service in England mandates the review of case reports of patients who have died, which should be translated into improved care for other patients. Case report: A 49-year-old Caucasian man sustained C-7 tetraplegia in a motorcycle accident in 1992. In 2009, he developed seizures and collapsed in the lavatory on a number of occasions during manual self-evacuation of his bowel. A 24-hour electrocardiogram recording at that time showed sinus rhythm with a maximum heart rate of 97 and a minimum of 39 beats per minute; there were no significant arrhythmias that could have contributed to his episodes of collapse...
2017: International Medical Case Reports Journal
https://www.readbyqxmd.com/read/29089975/autonomic-dysreflexia-a-cardiovascular-disorder-following-spinal-cord-injury
#15
REVIEW
Hisham Sharif, Shaoping Hou
Autonomic dysreflexia (AD) is a serious cardiovascular disorder in patients with spinal cord injury (SCI). The primary underlying cause of AD is loss of supraspinal control over sympathetic preganglionic neurons (SPNs) caudal to the injury, which renders the SPNs hyper-responsive to stimulation. Central maladaptive plasticity, including C-fiber sprouting and propriospinal fiber proliferation exaggerates noxious afferent transmission to the SPNs, causing them to release massive sympathetic discharges that result in severe hypertensive episodes...
September 2017: Neural Regeneration Research
https://www.readbyqxmd.com/read/28959508/autonomic-dysreflexia-in-the-peripartum-patient-a-multidisciplinary-and-interprofessional-simulation-scenario
#16
Purnima M Rao, Adam Garber, Chandrew Rajakumar, Genevieve Rousseau, George Dumitrascu, Glenn D Posner
This case is one of an eight-case multidisciplinary curriculum designed and implemented at the University of Ottawa by simulation educators with specialty training in obstetrics and gynecology (ob/gyn) and anesthesiology. Consultation with a nurse educator maintained quality and relevance of objectives for nursing participants. The curriculum was prepared to train ob/gyn and anesthesiology residents and nurses to hone crisis resource management skills and to recognize and manage rare/critical medical events in an obstetrical setting...
July 25, 2017: Curēus
https://www.readbyqxmd.com/read/28929040/cardiovascular-dysfunction-presenting-as-autonomic-dysreflexia-in-a-patient-with-spinal-cord-injury
#17
Ahmed H Qavi, Salman Assad, Wardha Shabbir, Maryam Kundi, Maham Habib, Sumbal Babar, Mehr Zahid
Autonomic dysreflexia (AD) is a medical emergency that is characterized by hypertension as an autonomic response to noxious stimuli in patients with a history of spinal cord injury at the level of T6 or above. We present the case of a 31-year-old Caucasian male with a history of spinal cord injury at the level of C3-C4, with symptoms described as recurring episodes of hypertension with flushing and sweating above the level of the lesion for the past five to six years. His symptoms are triggered by bowel distention, excitement, a bumpy car ride, or a simple turning of the neck to the left...
July 10, 2017: Curēus
https://www.readbyqxmd.com/read/28905348/-a-rare-complication-of-transrectal-electrostimulation-for-sperm-retrieval
#18
Jürgen Pannek, Dirk Leuth, Jens Wöllner
In men who wish to have children after a spinal cord injury, assisted ejaculation is frequently needed for sperm retrieval. Transrectal electrostimulation (TES) is often used for this purpose. Typical side effects of TES are autonomic dysreflexia or pain. In a 33-year old man with complete tetraplegia below C6 since 2004, TES caused massive leg spasticity, leading to transcervical fracture of the femoral neck. This previously unreported complication of TES demonstrates that, in men with long-term chronic tetraplegia, spasticity and osteoporosis, TES in anesthesia should be taken into consideration...
September 13, 2017: Aktuelle Urologie
https://www.readbyqxmd.com/read/28884476/probiotics-for-preventing-urinary-tract-infection-in-people-with-neuropathic-bladder
#19
REVIEW
Swee-Ling Toh, Claire L Boswell-Ruys, Bon San B Lee, Judy M Simpson, Kate R Clezy
BACKGROUND: Neuropathic or neurogenic bladder describes a process of dysfunctional voiding as the result of injury in the brain, spinal cord or nerves innervating the bladder. People with neuropathic bladder, such as from spinal cord injury (SCI), are at significant risk of morbidity from urinary tract infections (UTI). Effective methods to prevent UTI in people with SCI have been sought for many years. Probiotics (micro-organisms that exert beneficial health effects in the host) have been recommended for bacterial interference of the urological tract to reduce colonisation by uropathogen and to manage the dual problems of infection and antibiotic resistance...
September 8, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28782691/first-case-of-autonomic-dysreflexia-following-elective-lower-thoracic-spinal-cord-transection-in-a-spina-bifida-adult
#20
Juanita Garces, Mansour Mathkour, Tyler Scullen, Lora Kahn, Erin Biro, Alex Pham, Olawale A R Sulaiman, Roger Smith, Cuong J Bui
BACKGROUND: Spinal cord transection is a radical but effective treatment for highly selective cases of symptomatic spinal retethering in paraplegic spina bifida patients. Autonomic dysreflexia (AD) is a potentially life-threatening syndrome involving a dysregulated sympathetic discharge reflex commonly seen following cervical and high thoracic spinal cord injury, leading to a disconnect between autonomic pathways above and below the lesion that can lead to severe complications including uncontrolled hypertension, bradycardia, stroke, and potentially death...
December 2017: World Neurosurgery
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