Neurogenic Shock

Neurogenic shock is a condition in which blood flow becomes abnormal due to spinal cord injury. This condition, also called vasogenic shock, can be dangerous because it causes a sudden drop in blood pressure in the body (shock), damaging various body tissues. If nothing is done, neurogenic shock can be fatal. Therefore, early identification and prompt treatment is needed to prevent further damage to the spinal cord.

Neurogenic Shock
Symptoms of neurogenic shock

Neurogenic shock is an emergency that causes a decrease in blood pressure due to abnormal blood circulation. Apart from a decrease in blood pressure, neurogenic shock will also cause a low heart rate and a decrease in body temperature. This will cause symptoms such as dizziness, nausea, vomiting, loss of vision, fainting, excessive sweating, anxiety, and pale skin. In more severe stages, patients may experience shortness of breath, chest pain, blue lips and blue fingers (cyanosis).

Symptoms caused by spinal cord injury can occur immediately because of direct (primary) nerve injury or occur slowly, up to several hours or several days after injury (secondary). This secondary neurogenic shock usually results from spinal cord blood vessel lesions.
Causes of neurogenic shock

The cause of neurogenic shock is injury or trauma to the spinal cord. This results in nervous system dysfunction which regulates heart rate, blood pressure and breathing. This nervous system is known as the sympathetic nervous system. Altered sympathetic nervous system function causes a decrease in blood pressure, which interferes with blood flow to cells, tissues, and organs.

This spinal cord injury may be due to an injury during training, a gunshot wound or a traffic accident.
Diagnosis of neurogenic shock

The diagnosis is made quickly by knowing the history of events that can cause neurogenic shock and by conducting physical examinations on the patient, such as measuring blood pressure, pulse and body temperature. Neurogenic shock is an emergency that needs to be treated immediately to avoid fatal consequences.

After the patient's condition is stable, supportive examination, including CT scan, is needed to determine the severity of the injury that can cause neurogenic shock. With this analysis, the doctor can see the severity of the injury and determine whether there is internal bleeding or other lesions. Another test is MRI, which can show the structure of the inside of the body, especially the spine.
Neurogenic shock treatment

In patients with neurogenic shock, treatment must be done immediately to avoid permanent organ damage. Neurogenic shock therapy aims to stabilize the patient's vital signs, such as blood pressure, heart rate and breathing, and to prevent further injury or damage.

Management of neurogenic shock cases starts with minimizing changes in the patient's body position or by making the patient immobile, to prevent further damage. In addition, it is necessary to increase blood pressure by providing intravenous fluids and vasopressors which can increase blood vessel tension, such as dopamine, norepinephrine, epinephrine, and vasopressin. Meanwhile, to increase heart rate, doctors can give atropine to drugs.

If necessary, spinal surgery will be performed to repair damage to the injured spinal cord.

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