975 results match your criteria Autonomic Dysreflexia in Spinal Cord Injury

Pediatric Spina Bifida and Spinal Cord Injury.

J Pers Med 2022 Jun 17;12(6). Epub 2022 Jun 17.

Department of Physical Medicine and Rehabilitation, Miller School of Medicine, University of Miami, Miami, FL 33136, USA.

Pediatric spina bifida (SB) and spinal cord injury (SCI) are unfortunately common in our society, and their unique findings and comorbidities warrant special consideration. This manuscript will discuss the epidemiology, pathophysiology, prevention, and management strategies for children growing and developing with these unique neuromuscular disorders. Growth and development of the maturing child places them at high risk of spinal cord tethering, syringomyelia, ascending paralysis, pressure injuries, and orthopedic abnormalities that must be addressed frequently and judiciously. Read More

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Neurogenic Bladder Physiology, Pathogenesis, and Management after Spinal Cord Injury.

J Pers Med 2022 Jun 14;12(6). Epub 2022 Jun 14.

Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, Miami, FL 33136, USA.

Urinary incontinence is common after spinal cord injury (SCI) due to loss of supraspinal coordination and unabated reflexes in both autonomic and somatic nervous systems; if unchecked, these disturbances can become life-threatening. This manuscript will review normal anatomy and physiology of the urinary system and discuss pathophysiology secondary to SCI. This includes a discussion of autonomic dysreflexia, as well as its diagnosis and management. Read More

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Pharmacologic and Acute Management of Spinal Cord Injury in Adults and Children.

Curr Treat Options Neurol 2022 Jun 10:1-20. Epub 2022 Jun 10.

Division of Pediatric Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine, Houston, TX USA.

Purpose Of Review: This review provides guidance for acute spinal cord injury (SCI) management through an analytical assessment of the most recent evidence on therapies available for treating SCI, including newer therapies under investigation. We present an approach to the SCI patient starting at presentation to acute rehabilitation and prognostication, with additional emphasis on the pediatric population when evidence is available.

Recent Findings: Further studies since the Surgical Timing in Acute Spinal Cord Injury Study (STASCIS) demonstrated a potential functional outcome benefit with ultra-early surgical intervention ≤ 8 h post-SCI. Read More

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Heart rate changes associated with autonomic dysreflexia in daily life of individuals with chronic spinal cord injury.

Spinal Cord 2022 Jun 9. Epub 2022 Jun 9.

International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.

Study Design: Secondary data analysis.

Objective: To characterize heart rate (HR) changes during autonomic dysreflexia (AD) in daily life for individuals with chronic spinal cord injury (SCI).

Setting: University-based laboratory/community-based outpatient. Read More

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The past, present, and future of traumatic spinal cord injury therapies: a review.

Bone Jt Open 2022 May;3(5):348-358

Spinal Unit, Department of Neurosurgery, Hull Royal Infirmary, Hull, UK.

This review provides a concise outline of the advances made in the care of patients and to the quality of life after a traumatic spinal cord injury (SCI) over the last century. Despite these improvements reversal of the neurological injury is not yet possible. Instead, current treatment is limited to providing symptomatic relief, avoiding secondary insults and preventing additional sequelae. Read More

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Perioperative Complications and Anesthesia Practices in Managing Patients With Quadriplegia Undergoing Surgery: A Systematic Review.

Front Med (Lausanne) 2022 28;9:852892. Epub 2022 Mar 28.

Department of Anesthesiology and Pain Medicine, Toronto Western Hospital, University Health Network, Toronto, ON, Canada.

Quadriplegia is associated with a multitude of health complications affecting numerous organ systems. Complications during the perioperative periods are not uncommon in this patient population due to abnormal responses to surgical stressors. Such complications include autonomic dysreflexia, cardiac ischemia, and respiratory compromise. Read More

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Trans-Spinal Electrical Stimulation Therapy for Functional Rehabilitation after Spinal Cord Injury: Review.

J Clin Med 2022 Mar 11;11(6). Epub 2022 Mar 11.

Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China.

Spinal cord injury (SCI) is one of the most debilitating injuries in the world. Complications after SCI, such as respiratory issues, bowel/bladder incontinency, pressure ulcers, autonomic dysreflexia, spasticity, pain, etc., lead to immense suffering, a remarkable reduction in life expectancy, and even premature death. Read More

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Thoracic VGluT2 Spinal Interneurons Regulate Structural and Functional Plasticity of Sympathetic Networks after High-Level Spinal Cord Injury.

J Neurosci 2022 04 18;42(17):3659-3675. Epub 2022 Mar 18.

Department of Neuroscience, Center for Brain and Spinal Cord Repair, Belford Center for Spinal Cord Injury, Wexner Medical Center, The Ohio State University, Columbus, Ohio 43210

Traumatic spinal cord injury (SCI) above the major spinal sympathetic outflow (T6 level) disinhibits sympathetic neurons from supraspinal control, causing systems-wide "dysautonomia." We recently showed that remarkable structural remodeling and plasticity occurs within spinal sympathetic circuitry, creating abnormal sympathetic reflexes that exacerbate dysautonomia over time. As an example, thoracic VGluT2 spinal interneurons (SpINs) become structurally and functionally integrated with neurons that comprise the spinal-splenic sympathetic network and immunological dysfunction becomes progressively worse after SCI. Read More

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Role of Descending Serotonergic Fibers in the Development of Pathophysiology after Spinal Cord Injury (SCI): Contribution to Chronic Pain, Spasticity, and Autonomic Dysreflexia.

Biology (Basel) 2022 Feb 1;11(2). Epub 2022 Feb 1.

Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX 77843, USA.

As the nervous system develops, nerve fibers from the brain form descending tracts that regulate the execution of motor behavior within the spinal cord, incoming sensory signals, and capacity to change (plasticity). How these fibers affect function depends upon the transmitter released, the receptor system engaged, and the pattern of neural innervation. The current review focuses upon the neurotransmitter serotonin (5-HT) and its capacity to dampen (inhibit) neural excitation. Read More

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February 2022

Menstrual changes after spinal cord injury.

Spinal Cord 2022 Feb 15. Epub 2022 Feb 15.

Department of Physical Medicine & Rehabilitation, St. John's Medical College Hospital, Bengaluru, Karnataka, India.

Study Design: This was a single-centre, prospective, descriptive, hospital-based study in females with spinal cord injuries (SCI).

Objectives: To study menstrual changes after SCI.

Setting: The in-patient and out-patient services of the Department of Physical Medicine and Rehabilitation of a tertiary care institute in India between October 2018 and October 2020. Read More

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February 2022

The burst catheter balloon: A comparison of fragmentation rates and overinflation burst volumes in Foley catheters with special considerations in SCI.

J Spinal Cord Med 2022 Feb 2:1-6. Epub 2022 Feb 2.

Rutgers New Jersey Medical School, Department of Physical Medicine and Rehabilitation, Newark, NJ, USA.

Objective: The primary aim was to determine Foley catheter balloon burst volumes and the effect of latex Foley catheter size on balloon burst volume. The secondary aim was to measure the effect of Foley catheter material on free fragment formation rate. This study also focused on special considerations for those with neurogenic bladder and spinal cord injury at or above T6. Read More

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February 2022

Pregnancy, labor, and delivery outcomes of women with and without spinal cord injury.

J Spinal Cord Med 2022 Feb 2:1-9. Epub 2022 Feb 2.

Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan, USA.

Objectives: Compare outcomes in pregnant women with and without Spinal Cord Injury (SCI).

Design: Case study and inception cohort comparison.

Setting: Community, primary care/referral center and university practice. Read More

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February 2022

Special surgical aspects of radical cystectomy in spinal cord injury patients with bladder cancer.

World J Urol 2022 Jan 29. Epub 2022 Jan 29.

Leibniz Research Centre for Working Environment and Human Factors at TU Dortmund (IfADo), Dortmund, Germany.

Purpose: Radical cystectomy in people with spinal cord injury (SCI) provides numerous additional difficulties, compared to able-bodied people. Therefore, it is important to obtain information from an experienced team about optimally managing these patients.

Methods: Surgical procedures, based on the experience of 12 radical cystectomies in SCI patients with bladder cancer between January 1st, 2001, and December 31st, 2020, were recorded and the operative and perioperative clinical data were evaluated. Read More

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January 2022

Reduced Reflex Autonomic Responses Following Intradetrusor OnabotulinumtoxinA Injections: A Pre-/Post-study in Individuals With Cervical and Upper Thoracic Spinal Cord Injury.

Front Physiol 2021 15;12:796277. Epub 2021 Dec 15.

International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.

Urodynamic studies (UDS) can provoke autonomic dysreflexia (AD) in individuals with spinal cord injury (SCI) at and above the sixth thoracic spinal segment potentially leading to profound vagally mediated heart rate (HR) reductions. In this study, we test the hypothesis that intradetrusor onabotulinumtoxinA injections will improve HR and its variability (HRV) responses to UDS in individuals with cervical and thoracic SCI. A total of 19 participants with chronic SCI (5 women, mean age 42. Read More

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December 2021

Autonomic Dysreflexia After Hip Fractures Managed by Regional Anesthesia: A Case Report.

A A Pract 2022 Jan 11;16(1):e01556. Epub 2022 Jan 11.

Department of Anesthesiology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania.

Autonomic dysreflexia occurs after a spinal cord injury usually at the level of T6 or above, and its hallmark feature is exaggerated autonomic response to noxious stimuli resulting in uncontrolled hypertensive episodes with reflexive bradycardia that can be fatal if not controlled. We present a case highlighting regional anesthetic techniques, including peripheral nerve blocks, to ameliorate the symptoms of autonomic dysreflexia triggered by hip fractures in a 57-year-old woman with an old C5-C6 spinal cord injury before definitive hip surgery. The regional techniques described provide anesthesiologists with a simple strategy to potentially mitigate a life-threatening situation. Read More

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January 2022

Diagnostic and Therapeutic Particularities in Abdominal Trauma Associated with Spinal Cord Injuries - Review of the Literature.

Chirurgia (Bucur) 2021 Dec;116(6):669-677

Post-traumatic morbid associations may evolve by themselves, or can interact, with effects of adding or potentiating gravity. Sometimes cumulative or potentiating effects are associated with clinical and paraclinical confusing manifestations induced by one of the components of the lesion complex, or by mutually aggravating effects. It is also the case of vertebromedular traumas associated with other post-traumatic lesions, where the neurological signal is distorted, and may induce particularities of associated lesions. Read More

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December 2021

[Urinary Bladder Cancer as a Long-term Sequela of Spinal Cord Injury - Relevance to Practice].

Aktuelle Urol 2022 04 21;53(2):137-147. Epub 2021 Dec 21.

Klinische Arbeitsmedizin, Leibniz-Institut für Arbeitsforschung an der TU Dortmund, Dortmund, Germany.

Urinary bladder cancer is the second most common tumour disease after lung cancer leading to death in people with a spinal cord injury. This paper provides a comprehensive overview of the differences relevant to urologists between urinary bladder tumours in this population compared with urinary bladder tumours in the general population.People with a spinal cord injury are 1 to 2 decades younger on average at the time of tumour diagnosis than patients without a spinal cord injury. Read More

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Management of blood pressure disorders in individuals with spinal cord injury.

Jill M Wecht

Curr Opin Pharmacol 2022 02 13;62:60-63. Epub 2021 Dec 13.

James J Peters VA Medical Center, Department of Research & Development, USA; Icahn School of Medicine Mount Sinai, Departments of Rehabilitation and Human Performance, and Medicine, USA. Electronic address:

Blood pressure regulation is impacted by a spinal cord injury (SCI) due to impaired descending sympathetic vascular control. Common blood pressure problems in the SCI population include persistently low blood pressure with bouts of orthostatic hypotension and autonomic dysreflexia, which are more prevalent in individuals with lesions above the sixth thoracic vertebral level; however, they may occur regardless of the neurological level of injury. Although blood pressure disorders adversely impact daily function and quality of life, most individuals with SCI do not acknowledge this association. Read More

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February 2022

Peripherally delivered Adeno-associated viral vectors for spinal cord injury repair.

Exp Neurol 2022 02 8;348:113945. Epub 2021 Dec 8.

Neurorestoration Group, Wolfson Centre for Age-Related Diseases, King's College London, University of London, 16-20 Newcomen Street, London SE1 1UL, United Kingdom. Electronic address:

Via the peripheral and autonomic nervous systems, the spinal cord directly or indirectly connects reciprocally with many body systems (muscular, intengumentary, respiratory, immune, digestive, excretory, reproductive, cardiovascular, etc). Accordingly, spinal cord injury (SCI) can result in catastrophe for multiple body systems including muscle paralysis affecting movement and loss of normal sensation, as well as neuropathic pain, spasticity, reduced fertility and autonomic dysreflexia. Treatments and cure for an injured spinal cord will likely require access of therapeutic agents across the blood-CNS (central nervous system) barrier. Read More

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February 2022

An Assessment of Which Sociodemographic and Spinal Cord Injury-Specific Characteristics Influence Engagement With Experimental Therapies and Participation in Clinical Trials.

Top Spinal Cord Inj Rehabil 2021 17;27(4):28-39. Epub 2021 Nov 17.

Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania.

Although a number of experimental therapies for spinal cord injury (SCI) have recently emerged, few authors have examined the goals of individuals with SCI considering experimental therapies, and none have determined whether sociodemographic and injury-specific characteristics influence that engagement. To determine (a) the goals of individuals with SCI who are considering experimental therapies; (b) whether sociodemographic factors, injury-specific characteristics, and concerns over adverse events influence those goals and/or participation in experimental therapies and clinical trials; and (c) whether people with SCI feel they have adequate information about experimental therapies and clinical trials. An online survey that yielded 364 responses. Read More

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December 2021

Nurses and physiotherapists' knowledge levels on autonomic dysreflexia in a rehabilitation hospital.

Ercan Kaydok

J Spinal Cord Med 2021 Dec 2:1-5. Epub 2021 Dec 2.

Department of Physical Medicine and Rehabilitation, Niğde Ömer Halisdemir University Faculty of Medicine, Niğde, Turkey.

Objective: Autonomic dysreflexia is a clinical syndrome that affects people with spinal cord lesions at or above the sixth thoracic vertebral level (T6). This study aims to determine the level of knowledge about autonomic dysreflexia among nurses and physiotherapists involved in spinal cord rehabilitation.

Design: Single-center survey study. Read More

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December 2021

[Autonomic dysreflexia in spinal cord injury patients: recognition is vital].

Ned Tijdschr Geneeskd 2021 09 30;165. Epub 2021 Sep 30.

Sint Maartenskliniek, afd. Revalidatiegeneeskunde, Nijmegen.

Depending on the level and severity of spinal cord injury (SCI), SCI patients may suffer from loss of autonomic nervous system function besides the well-known motor and sensory function loss. Changes in the autonomic control of the cardiovascular system can lead to the life-threatening phenomenon of autonomic dysreflexia (AD), especially in patients with cervical or high thoracic SCI. AD is defined as a sudden increase in systolic blood pressure of at least 20 mmHg above baseline. Read More

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September 2021

Toward rebalancing blood pressure instability after spinal cord injury with spinal cord electrical stimulation: A mini review and critique of the evolving literature.

Auton Neurosci 2022 01 11;237:102905. Epub 2021 Nov 11.

Spaulding Rehabilitation Hospital, 300 First Ave, Boston, MA 02129, USA; Department of Physical Medicine & Rehabilitation, Harvard Medical School, 300 First Ave, Boston, MA 02129, USA; Spaulding Research Institute, 300 First Ave, Boston, MA 02129, USA. Electronic address:

High-level spinal cord injury commonly leads to blood pressure instability. This manifests clinically as orthostatic hypotension (OH), where blood pressure can drop to the point of loss of consciousness, and autonomic dysreflexia (AD), where systolic blood pressure can climb to over 300 mmHg in response to an unperceived noxious stimulus. These blood pressure fluctuations can occur multiple times a day, contributing to increased vessel shear stress and heightened risk of cardiovascular disease. Read More

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January 2022

Influence of severity and level of injury on the occurrence of complications during the subacute and chronic stage of traumatic spinal cord injury: a systematic review.

J Neurosurg Spine 2022 Apr 12;36(4):632-652. Epub 2021 Nov 12.

2Department of Neurosurgery, Haaglanden Medical Center, The Hague.

Objective: Secondary health conditions (SHCs) are long-term complications that frequently occur due to traumatic spinal cord injury (tSCI) and can negatively affect quality of life in this patient population. This study provides an overview of the associations between the severity and level of injury and the occurrence of SHCs in tSCI.

Methods: A systematic search was conducted in PubMed and Embase that retrieved 44 studies on the influence of severity and/or level of injury on the occurrence of SHCs in the subacute and chronic phase of tSCI (from 3 months after trauma). Read More

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Passive leg cycling increases activity of the cardiorespiratory system in people with tetraplegia.

Appl Physiol Nutr Metab 2022 Mar 5;47(3):269-277. Epub 2021 Nov 5.

Department of Integrative Physiology, School of Medicine, University of Split, Split, Croatia.

Individuals with cervical spinal cord injury (SCI) are at an increased risk for cardiovascular disease. Exercise is well-established for preventing cardiovascular disease; however, there are limited straightforward and safe exercise approaches for increasing the activity of the cardiorespiratory system after cervical SCI. The objective of this study was to investigate the cardiorespiratory response to passive leg cycling in people with cervical SCI. Read More

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Disruption of sensation-dependent bladder emptying due to bladder overdistension in a complete spinal cord injury: A case report.

World J Clin Cases 2021 Oct;9(29):8946-8952

Department of Physical Medicine and Rehabilitation, Jeonbuk National University Medical School, Korea Research Institute of Clinical Medicine of Jeonbuk National University - Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju 54097, Jeonbuk, South Korea.

Background: Autonomic dysreflexia (AD) can be a life-threatening condition in patients with spinal cord injury. It is important to prevent bladder overdistension in these patients as it may trigger AD. Sensation-dependent bladder emptying (SDBE), as a method of bladder management, improves the quality of life and allows physiologic voiding. Read More

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October 2021

Resveratrol promotes axonal regeneration after spinal cord injury through activating Wnt/β-catenin signaling pathway.

Aging (Albany NY) 2021 10 14;13(20):23603-23619. Epub 2021 Oct 14.

Department of Orthopaedics, The 900th Hospital, Joint Logistics Support Force, Fuzhou 350025, Fujian Province, P.R. China.

Background: Spinal cord injury (SCI) is characterized by autonomic dysreflexia, chronic pain, sensory and motor deficits. Resveratrol has shown potential neuroprotective function in several neurodegenerative diseases' models. However, if resveratrol could improve the function recovery after SCI and the further mechanism have not been investigated. Read More

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October 2021

Noninvasive spinal stimulation safely enables upright posture in children with spinal cord injury.

Nat Commun 2021 10 6;12(1):5850. Epub 2021 Oct 6.

Department of Neurological Surgery, University of Louisville, Louisville, KY, USA.

In children with spinal cord injury (SCI), scoliosis due to trunk muscle paralysis frequently requires surgical treatment. Transcutaneous spinal stimulation enables trunk stability in adults with SCI and may pose a non-invasive preventative therapeutic alternative. This non-randomized, non-blinded pilot clinical trial (NCT03975634) determined the safety and efficacy of transcutaneous spinal stimulation to enable upright sitting posture in 8 children with trunk control impairment due to acquired SCI using within-subject repeated measures study design. Read More

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October 2021