Cardiovascular abnormalities accompanying acute spinal cord injury in humans: incidence, time course and severity
KG Lehmann,
JG Lane,
JM Piepmeier,
and
WP Batsford
The frequency of cardiovascular abnormalities was evaluated in 71 consecutive patients with acute injury to the spinal cord. Persistent bradycardia was universal in all 31 patients with severe cervical cord injury and less common in milder cervical injury (6 of 17) or thoracolumbar injury (3 of 23) (p less than 0.00001). Marked sinus slowing (71 versus 12 versus 4%, respectively, p less than 0.00001), hypotension (68 versus 0 versus 0%, p less than 0.00001), supraventricular arrhythmias (19 versus 6 versus 0%, p = 0.05) and primary cardiac arrest (16 versus 0 versus 0%, p less than 0.05) were significantly more frequent in the severe cervical injury group. The frequency of bradyarrhythmias peaked on day 4 after injury and gradually declined thereafter. All observed abnormalities resolved spontaneously within 2 to 6 weeks. The primary mechanism underlying these observations appears to involve the acute autonomic imbalance created by the disruption of sympathetic pathways located in the cervical cord. Acute severe injury to the cervical spinal cord is regularly accompanied by arrhythmias and hemodynamic abnormalities not found with thoracolumbar cord trauma. These abnormalities are limited to the first 14 days after injury, a period in which life-threatening disturbances must be anticipated.
This article has been cited by other articles:
|
|
|
|
 
M. Peyrol, P. Sbragia, J. A. Trigano, and F. Paganelli
Dorsal spinal cord injury as a cause of recurrent asystole requiring permanent cardiac pacing
Europace,
January 1, 2012;
14(1):
146 - 147.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. C. Furlan
Headache attributed to autonomic dysreflexia: An underrecognized clinical entity
Neurology,
August 23, 2011;
77(8):
792 - 798.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. Y. Yoo, C. W. Jeong, S. J. Kim, S. T. Jeong, S. H. Kwak, M. H. Shin, and J. Lee
Altered cardiovascular responses to tracheal intubation in patients with complete spinal cord injury: relation to time course and affected level
Br. J. Anaesth.,
December 1, 2010;
105(6):
753 - 759.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. Y. Yoo, C. W. Jeong, S. J. Kim, S. T. Jeong, M. H. Shin, and J. Lee
Cardiovascular and arousal responses to laryngoscopy and tracheal intubation in patients with complete spinal cord injury
Br. J. Anaesth.,
January 1, 2009;
102(1):
69 - 75.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. C. Aslan, D. C. Randall, K. D. Donohue, C. F. Knapp, A. R. Patwardhan, S. M. McDowell, R. F. Taylor, and J. M. Evans
Blood pressure regulation in neurally intact human vs. acutely injured paraplegic and tetraplegic patients during passive tilt
Am J Physiol Regulatory Integrative Comp Physiol,
March 1, 2007;
292(3):
R1146 - R1157.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. F. Bilello, J. W. Davis, M. A. Cunningham, T. F. Groom, D. Lemaster, and L. P. Sue
Cervical Spinal Cord Injury and the Need for Cardiovascular Intervention
Arch Surg,
October 1, 2003;
138(10):
1127 - 1129.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. Y. Yoo, S. W. Jeong, S. J. Kim, I. H. Ha, and J. Lee
Cardiovascular Responses to Endotracheal Intubation in Patients with Acute and Chronic Spinal Cord Injuries
Anesth. Analg.,
October 1, 2003;
97(4):
1162 - 1167.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. Demirel, S. Demirel, H. Yilmaz, V. Akkaya, D. Atilgan, and F. Korkut
Cardiac Dysrhythmias and Autonomic Dysfunction in Chronic Spinal Cord Injury: A 24-Hour Holter Monitoring and Heart Rate Variability Study
Neurorehabil Neural Repair,
December 1, 1999;
13(4):
235 - 241.
[Abstract]
[PDF]
|
|
|
|
