842 results match your criteria Autonomic Dysreflexia in Spinal Cord Injury


Development of a decerebrate model for investigating mechanisms mediating viscero-sympathetic reflexes in the spinalized rat.

Am J Physiol Heart Circ Physiol 2019 Mar 15. Epub 2019 Mar 15.

Emergency Medicine, Wayne State University School of Medicine, United States.

Autonomic dysreflexia (AD) often occurs in individuals living with spinal cord injury (SCI) and is characterized by uncontrolled hypertension in response to otherwise innocuous stimuli originating below the level of the spinal lesion. Visceral stimulation is a predominate cause of AD in humans, and effectively replicates the phenotype in rodent models of SCI. Direct assessment of sympathetic responses to viscerosensory stimulation in spinalized animals is challenging and requires invasive surgical procedures necessitating the use of anesthesia. Read More

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http://dx.doi.org/10.1152/ajpheart.00724.2018DOI Listing
March 2019
1 Read

Autonomic Dysreflexia in Patients With Spinal Cord Injury: What the Radiologist Needs to Know.

AJR Am J Roentgenol 2019 Mar 12:1-5. Epub 2019 Mar 12.

1 Department of Radiology, University of British Columbia, Vancouver General Hospital, 899 W 12th Ave, Vancouver, BC V5Z 1M9, Canada.

Objective: Autonomic dysreflexia (AD) is a potentially life-threatening condition that occurs in patients with cervical and high thoracic spinal cord injury (SCI). AD is not completely understood and has a high incidence that increases proportional to the level and severity of the SCI. The signs and symptoms can vary, but severe hypertension is a dominant feature and may be fatal. Read More

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https://www.ajronline.org/doi/10.2214/AJR.18.20798
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http://dx.doi.org/10.2214/AJR.18.20798DOI Listing
March 2019
3 Reads

Atlantoaxial Instability Resulting in Intractable Nausea in a Person with C5 Complete Spinal Cord Injury: A Case Report.

PM R 2019 Apr 19;11(4):440-445. Epub 2019 Feb 19.

Division of Neurosurgery, University of Missouri School Medicine, Columbia, MO 65212.

Individuals with spinal cord injury (SCI) have altered neurophysiology and present with symptoms that must be interpreted in the context of their specific neurologic injury. This is a case of a 16-year-old female adolescent with C5 American Spinal Injury Association Impairment Scale A SCI who presented with intractable nausea. Multiple etiologies for her nausea, including medication effect, metabolic and gastrointestinal disorders, autonomic dysreflexia, and mood disorder, were systematically ruled out. Read More

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http://dx.doi.org/10.1002/pmrj.12004DOI Listing

Medical and surgical management of acute spinal injury during pregnancy: A case series in a third-world country.

Surg Neurol Int 2018 24;9:258. Epub 2018 Dec 24.

Department of Neurosurgery, Juha Hernesniemi International Neurosurgery Center, Henan Provincial People's Hospital, 7 Weiwu Road, Zhengzhou, China.

Background: There is scant literature describing the management of acute spinal injury in pregnant patients. Here, we report our experience with five cases of pregnant patients including three females who suffered acute traumatic spinal cord injuries (SCIs).

Methods: This retrospective study evaluated five pregnant women presenting with traumatic spinal injuries over a 16-month period. Read More

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http://dx.doi.org/10.4103/sni.sni_380_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6322169PMC
December 2018
2 Reads

Protocol for a phase II, open-label exploratory study investigating the efficacy of fesoterodine for treatment of adult patients with spinal cord injury suffering from neurogenic detrusor overactivity for amelioration of autonomic dysreflexia.

BMJ Open 2018 Nov 21;8(11):e024084. Epub 2018 Nov 21.

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

Introduction: Managing and preventing risk factors associated with cardiovascular and cerebrovascular impairment is well studied in able-bodied individuals. However, individuals with spinal cord injury (SCI) at or above the spinal segment T6 are prone to experience autonomic dysreflexia (AD) but also to suffer from neurogenic detrusor overactivity (NDO). Treatment of NDO would not only improve lower urinary tract function but could also reduce the severity and frequency of life-threatening episodes of AD. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-024084DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6252748PMC
November 2018
4 Reads

Maxillomandibulocardiac reflex in a dog.

Acta Vet Scand 2018 Oct 29;60(1):64. Epub 2018 Oct 29.

Department of Animal Medicine, Production and Health, University of Padua, Viale dell'Università 16, 35020, Legnaro, PD, Italy.

Background: The trigeminocardiac reflex (TCR) is a brainstem reflex that may be observed in anaesthesia during surgical procedures stimulating the intracranial or peripheral portion of the trigeminal nerve. The peripheral TCR is divided into the oculocardiac reflex and the maxillomandibulocardiac reflex based on the affected sensory branches of the trigeminal nerve. In veterinary medicine the oculocardiac reflex has been described, however the maxillomandibulocardiac reflex has never been reported. Read More

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http://dx.doi.org/10.1186/s13028-018-0421-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6206717PMC
October 2018
4 Reads

Development of Cardiovascular Dysfunction in a Rat Spinal Cord Crush Model and Responses to Serotonergic Interventions.

J Neurotrauma 2019 Jan 8. Epub 2019 Jan 8.

Spinal Cord Research Center, Department of Neurobiology and Anatomy, Drexel University College of Medicine, Philadelphia, Pennsylvania.

Selection of a proper spinal cord injury (SCI) rat model to study therapeutic effects of cell transplantation is imperative for research in cardiovascular functional recovery, due to the local harsh milieu inhibiting cell growth. We recently found that a crushed spinal cord lesion can minimize fibrotic scarring and grafted cell death compared with open-dura injuries. To determine if this SCI model is applicable for studying cardiovascular recovery, we examined hemodynamic consequences following crushed SCI and tested cardiovascular responses to serotonin (5-HT) or dopamine (DA) receptor agonists. Read More

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http://dx.doi.org/10.1089/neu.2018.5962DOI Listing
January 2019
11 Reads

A custom made interface to integrate recording of pulse rate and blood pressure during urodynamics investigations.

J Med Eng Technol 2018 Oct 16:1-8. Epub 2018 Oct 16.

a Medical Physics Department , James Cook University Hospital , Middlesbrough , UK.

Patients with a spinal cord injury above the 6th thoracic vertebrae may be prone to autonomic dysreflexia (AD) in response to bladder stimulus associated with a urodynamics investigation. It is essential that these patients are managed carefully in the urodynamics clinic in order to prevent life-threatening hypertension and bradycardia. Part of this management is the measurement and manual recording of pulse rate (PR) and non-invasive blood pressure (NIBP), alongside the standard urodynamics data set. Read More

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https://www.tandfonline.com/doi/full/10.1080/03091902.2018.1
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http://dx.doi.org/10.1080/03091902.2018.1513577DOI Listing
October 2018
6 Reads

Distinct roles of angiotensin receptors in autonomic dysreflexia following high-level spinal cord injury in mice.

Exp Neurol 2019 01 10;311:173-181. Epub 2018 Oct 10.

Max Delbrück Center for Molecular Medicine (MDC) in the Helmholtz Association, Berlin, Germany; Berlin Institute of Health (BIH), Berlin, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany; Institute for Biology, University of Lübeck, Lübeck, Germany.

Autonomic dysreflexia (AD), a syndrome caused by loss of supraspinal control over sympathetic activity and amplified vascular reflex upon sensory stimuli below injury level, is a major health problem in high-level spinal cord injury (SCI). After supraspinal sympathetic control of the vasculature below the lesion is lost, the renin-angiotensin system (RAS) is thought to be involved in AD by regulating blood pressure and vascular reactivity. In this study, we aimed to assess the role of different RAS receptors during AD following SCI. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00144886183056
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http://dx.doi.org/10.1016/j.expneurol.2018.10.003DOI Listing
January 2019
19 Reads

Ancillary benefits of bladder chemodenervation for SCI neurogenic bladder.

Spinal Cord Ser Cases 2018 11;4:83. Epub 2018 Sep 11.

Department of Urology, University of Washington, Seattle, WA USA.

Study Design: Case series.

Objective: Bladder chemodenervation is effective in treating neurogenic detrusor overactivity (NDO) in patients with neurogenic bladder due to spinal cord injury. Anecdotal reports also describe the improvement of non-bladder symptoms, specifically those related to autonomic dysreflexia (AD) and muscle spasticity. Read More

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http://dx.doi.org/10.1038/s41394-018-0116-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6134122PMC
September 2018
8 Reads

Anxiety masquerading as autonomic dysreflexia.

J Spinal Cord Med 2018 Sep 10:1-4. Epub 2018 Sep 10.

c Kessler Institute for Rehabilitation , West Orange , New Jersey , USA.

Context: Autonomic dysreflexia (AD) is characterized by a sudden onset of hypertension in those with spinal cord injuries (SCI) at T6 or above. Prompt recognition and treatment of AD is important. Herein are two individuals with SCI and acute hypertension due to anxiety that may easily have been confused for AD. Read More

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http://dx.doi.org/10.1080/10790268.2018.1518763DOI Listing
September 2018
4 Reads

Intravesical lidocaine decreases autonomic dysreflexia when administered prior to catheter change.

J Spinal Cord Med 2018 Sep 10:1-5. Epub 2018 Sep 10.

c Kessler Institute for Rehabilitation , West Orange, West Orange , New Jersey , USA.

Objective: To evaluate the role of intravesical lidocaine in preventing autonomic dysreflexia (AD) during routine catheter changes in individuals with spinal cord injury (SCI) at T6 or above.

Design: Prospective observational cohort study.

Setting: Outpatient urology clinic. Read More

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https://www.tandfonline.com/doi/full/10.1080/10790268.2018.1
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http://dx.doi.org/10.1080/10790268.2018.1518764DOI Listing
September 2018
4 Reads

Functional independence of persons with long-standing motor complete spinal cord injury in the Netherlands.

J Spinal Cord Med 2018 Aug 20:1-8. Epub 2018 Aug 20.

b Department of Rehabilitation Medicine , University of Groningen, University Medical Center Groningen , Groningen , the Netherlands.

Context/objective: Since life expectancy of persons with spinal cord injury (SCI) has improved, it is relevant to know whether this group is able to maintain functional abilities many years after onset of SCI. Objectives of this study were (1) to examine associations between time since injury (TSI) and functional independence in persons with long-standing SCI and (2) to explore associations between functional independence and level of injury, comorbidities, mental health, waist circumference and secondary health conditions (SHCs).

Design: TSI-stratified cross-sectional study. Read More

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http://dx.doi.org/10.1080/10790268.2018.1504427DOI Listing
August 2018
20 Reads

Transient anisocoria after a traumatic cervical spinal cord injury: A case report.

J Spinal Cord Med 2018 Aug 20:1-4. Epub 2018 Aug 20.

a Department of Physical Medicine and Rehabilitation , Penn State Health Milton S. Hershey Medical Center , Hershey , Pennsylvania , USA.

Context: Autonomic dysreflexia and dysautonomia can be a common complication following spinal cord injury, especially at levels of T6 and above and can lead to complications associated with the pupil. In this case report, we review autonomic dysreflexia, the anatomy and physiology of the sympathetic nervous system of the eye, as well as review the clinical relevance in understanding autonomic and pupillary changes in response to autonomic dysfunction.

Findings: We present a patient with an incomplete C4 level injury who was found to have isolated anisocoria on two separate occasions during his acute inpatient rehabilitation stay. Read More

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http://dx.doi.org/10.1080/10790268.2018.1509532DOI Listing
August 2018
29 Reads

Minocycline Reduces the Severity of Autonomic Dysreflexia after Experimental Spinal Cord Injury.

J Neurotrauma 2018 Dec 8;35(24):2861-2871. Epub 2018 Sep 8.

1 International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada.

Spinal cord injury (SCI) is a devastating neurological condition for which there is no effective treatment to restore neurological function. The development of new treatments for those with SCI may be hampered by the insensitivity of clinical tools to assess motor function in humans. Treatments aimed at preserving neuronal function through anti-inflammatory pathways (i. Read More

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https://www.liebertpub.com/doi/10.1089/neu.2018.5703
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http://dx.doi.org/10.1089/neu.2018.5703DOI Listing
December 2018
12 Reads

Effect of Unintentional Boosting on Exercise Performance in a Tetraplegic Athlete.

Med Sci Sports Exerc 2018 Dec;50(12):2398-2400

School of Kinesiology, University of British Columbia, Vancouver, BC, CANADA.

Boosting is the induction of autonomic dysreflexia (AD) to reflexively activate otherwise dormant thoracolumbar sympathetic circuitry to "boost" the capacity of the cardiovascular system and enhance exercise performance. AD is a life-threatening condition unique to individuals with spinal cord injury (SCI) characterized by a sudden increase in sympathetic activity below the level of the SCI. Here we report on the temporal HR response to an episode of unintentional boosting during a validated field-based exercise performance test in an athlete with tetraplegia. Read More

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http://dx.doi.org/10.1249/MSS.0000000000001738DOI Listing
December 2018
18 Reads

Potential for lowering the risk of autonomic dysreflexia by means of transversus abdominis plane block in a paraplegic patient for cesarean delivery.

Int J Obstet Anesth 2018 Nov 3;36:134-135. Epub 2018 Jul 3.

Department of Anesthesiology and Intensive Care, Innsbruck Medical University, Innsbruck, Austria.

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http://dx.doi.org/10.1016/j.ijoa.2018.06.006DOI Listing
November 2018
2 Reads

Autonomic Dysreflexia as a Potential Adverse Effect of Duloxetine and Amitriptyline Combination Therapy: A Case Report.

PM R 2019 Feb 8;11(2):214-218. Epub 2019 Feb 8.

University of Washington, Spinal Cord Injury Service, VA Puget Sound Health Care System, 1660 S Columbian Way, S-128-SCI, Seattle, WA 98108.

Pharmacologic triggers of autonomic dysreflexia (AD) have rarely been described. This report describes the case of a 31-year-old woman with T3 American Spinal Injury Association Impairment Scale A spinal cord injury who developed recurrent AD while receiving duloxetine and amitriptyline combination therapy for neuropathic pain. After excluding other AD generators, duloxetine was discontinued and the AD episodes resolved. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S19341482183038
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http://dx.doi.org/10.1016/j.pmrj.2018.07.010DOI Listing
February 2019
4 Reads

The spleen as a neuroimmune interface after spinal cord injury.

J Neuroimmunol 2018 Aug 24;321:1-11. Epub 2018 May 24.

Department of Neuroscience, Center for Brain and Spinal Cord Repair, Wexner Medical Center, The Ohio State University, Columbus 43210, OH, USA. Electronic address:

Traumatic spinal cord injury (SCI) causes widespread damage to neurons, glia and endothelia located throughout the spinal parenchyma. In response to the injury, resident and blood-derived leukocytes orchestrate an intraspinal inflammatory response that propagates secondary neuropathology and also promotes tissue repair. SCI also negatively affects autonomic control over peripheral immune organs, notably the spleen. Read More

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http://dx.doi.org/10.1016/j.jneuroim.2018.05.007DOI Listing
August 2018
31 Reads

Fertility and sexuality in the spinal cord injury patient.

World J Urol 2018 Oct 14;36(10):1577-1585. Epub 2018 Jun 14.

University of British Columbia, Vancouver, BC, Canada.

Background: After a spinal cord injury, patients have different perceptions of sexuality, sexual function, and potential for fertility. These changes can greatly impact quality of life over a lifetime.

Purpose: The purpose of this workgroup was to identify common evidence based or expert opinion themes and recommendations regarding treatment of sexuality, sexual function and fertility in the spinal cord injury population. Read More

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http://dx.doi.org/10.1007/s00345-018-2347-yDOI Listing
October 2018
18 Reads

Management of autonomic dysreflexia associated with Charcot spinal arthropathy in a patient with complete spinal cord injury: Case report and review of the literature.

Surg Neurol Int 2018 29;9:113. Epub 2018 May 29.

Department of Neurosurgery, University of Cincinnati College of Medicine, and Mayfield Clinic, Cincinnati, Ohio, USA.

Background: Charcot spinal arthropathy (CSA) clearly represents a challenge in long-term spinal cord injury patients, one that can have extremely uncomfortable and potentially lethal outcomes if not managed properly.

Case Description: A 66-year-old man with a history of complete C7 quadriplegia presented with new-onset autonomic dysreflexia that resulted from Charcot spinal arthropathy (CSA). Pathologic instability, in the atypical site of the mid-thoracic spine, spanning from the T8-T9 vertebral levels was appreciated on physical exam as an audible, palpable, and visible dynamic kyphosis; kyphosis was later confirmed on neuroimaging. Read More

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http://dx.doi.org/10.4103/sni.sni_287_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5991269PMC
May 2018
17 Reads

Muscle invasive bladder cancer presenting as recurrent autonomic dysreflexia - a wolf in wolf's clothing.

J Spinal Cord Med 2018 Jun 20:1-4. Epub 2018 Jun 20.

b Vesia [Alberta Bladder Centre], Department of Surgery , University of Calgary , Calgary, Alberta , Canada.

Context: Autonomic dysreflexia is a potentially lethal condition experienced by spinal cord injury (SCI) patients. It has a wide range of causes, most of which are genitourinary in nature. However, there has been no documented case of primary bladder cancer as a trigger for recurrent autonomic dysreflexia. Read More

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http://dx.doi.org/10.1080/10790268.2018.1487188DOI Listing
June 2018
2 Reads

Persons With Chronic Spinal Cord Injuries in the Emergency Department: a Review of a Unique Population.

J Emerg Med 2018 08 26;55(2):206-212. Epub 2018 May 26.

Department of Rehabilitation Medicine, Magee Rehabilitation Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.

Background: Persons with spinal cord injuries (SCIs) are frequent utilizers of emergency medical services but are a poorly understood and medically complex population. As the treatment of acute spinal cord injuries improves, there is a growing population of patients suffering from the chronic neurological deficits and altered homeostasis resulting from those injuries.

Objectives: We sought to highlight the unique diagnostic challenges of treating persons with SCIs and to review ailments uncommon in the general population but often encountered in this population. Read More

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http://dx.doi.org/10.1016/j.jemermed.2018.04.029DOI Listing
August 2018
5 Reads

The Feasibility of Blood Flow Restriction Exercise in Patients With Incomplete Spinal Cord Injury.

PM R 2018 Dec 23;10(12):1368-1379. Epub 2018 May 23.

Kent State University, Kent, OH; and Louis Stokes Cleveland VA Medical Center, Cleveland, OH(#).

Background: Blood flow restriction (BFR) exercise, which already has shown promise in the able-bodied population, may be a novel method for improving muscle function in the incomplete spinal cord injury (iSCI) population. However, the feasibility and tolerance for BFR exercise in this population is unknown.

Objective: To determine the feasibility and safety of BFR exercise in the iSCI population, with special attention paid to acute hemodynamic changes and the risk of deep vein thrombosis (DVT). Read More

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http://dx.doi.org/10.1016/j.pmrj.2018.05.013DOI Listing
December 2018
3 Reads

The Influence of Spinal Cord Injury on Breastfeeding Ability and Behavior.

J Hum Lact 2018 Aug 22;34(3):556-565. Epub 2018 May 22.

2 Experimental Medicine Program, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.

Background: Lactation dysfunction following spinal cord injury has been noted in the literature. However, researchers have often grouped together all women of physical disability or do not account for injury level. The extent of lactation dysfunction and influence of spinal cord injury on breastfeeding ability and behavior is not well understood. Read More

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http://dx.doi.org/10.1177/0890334418774014DOI Listing
August 2018
12 Reads

Improving primary care for persons with spinal cord injury: Development of a toolkit to guide care.

J Spinal Cord Med 2018 May 7:1-10. Epub 2018 May 7.

c Toronto Rehabilitation Institute, Lyndhurst Centre , University Health Network , Toronto , Ontario , Canada.

Objective: To identify a set of essential components for primary care for patients with spinal cord injury (SCI) for inclusion in a point-of-practice toolkit for primary care practitioners (PCP) and identification of the essential elements of SCI care that are required in primary care and those that should be the focus of specialist care.

Design: Modified Delphi consensus process; survey methodology.

Setting: Primary care. Read More

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http://dx.doi.org/10.1080/10790268.2018.1468584DOI Listing
May 2018
19 Reads

Autonomic dysreflexia following acute myelitis due to neuromyelitis optica.

Authors:
Julio C Furlan

Mult Scler Relat Disord 2018 Jul 16;23:1-3. Epub 2018 Apr 16.

Lyndhurst Centre, Toronto Rehabilitation Institute, University Health Network, 520 Sutherland Drive, Toronto, Ontario, M4G 3V9, Canada; Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Toronto, Canada. Electronic address:

Background: Cardiovascular autonomic dysfunction is a relatively common secondary complication of tetraplegia. In addition to low baseline arterial blood pressure, tetraplegics can develop sudden-onset hypertensive episodes associated with a variety of symptoms and signs (so-called autonomic dysreflexia). Unfortunately, this potentially life-threatening medical entity is often overlooked and mismanaged. Read More

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http://dx.doi.org/10.1016/j.msard.2018.04.007DOI Listing
July 2018
6 Reads

Prediction of autonomic dysreflexia during urodynamics: a prospective cohort study.

BMC Med 2018 04 13;16(1):53. Epub 2018 Apr 13.

Neuro-Urology, Spinal Cord Injury Center & Research, University of Zürich, Balgrist University Hospital, Zürich, Switzerland.

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. Read More

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http://dx.doi.org/10.1186/s12916-018-1040-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5898013PMC
April 2018
6 Reads

Persistent urine leakage around a suprapubic catheter: the experience of a person with chronic tetraplegia.

Spinal Cord Ser Cases 2018 4;4:31. Epub 2018 Apr 4.

1Regional Spinal Injuries Centre, Southport and Formby District General Hospital, Town Lane, Southport, PR8 6PN UK.

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. Read More

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http://dx.doi.org/10.1038/s41394-018-0058-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5884805PMC
April 2018
9 Reads

Soluble TNFα Signaling within the Spinal Cord Contributes to the Development of Autonomic Dysreflexia and Ensuing Vascular and Immune Dysfunction after Spinal Cord Injury.

J Neurosci 2018 Apr 2;38(17):4146-4162. Epub 2018 Apr 2.

Department of Neurobiology and Anatomy, Drexel University College of Medicine, Philadelphia, Pennsylvania 19129,

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. Read More

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http://dx.doi.org/10.1523/JNEUROSCI.2376-17.2018DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5963850PMC
April 2018
9 Reads
1 Citation
6.340 Impact Factor

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.

Int Med Case Rep J 2018 7;11:53-58. Epub 2018 Mar 7.

Regional Spinal Injuries Centre.

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. Read More

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http://dx.doi.org/10.2147/IMCRJ.S143077DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5848667PMC
March 2018
6 Reads

Positive airway pressure therapy for sleep-disordered breathing confers short-term benefits to patients with spinal cord injury despite widely ranging patterns of use.

Spinal Cord 2018 08 7;56(8):777-789. Epub 2018 Mar 7.

Pulmonary and Critical Care Medicine Division, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, 48109, USA.

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. Read More

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http://dx.doi.org/10.1038/s41393-018-0077-zDOI Listing
August 2018
8 Reads

The knowledge about autonomic dysreflexia among nursing and physiotherapy students.

J Spinal Cord Med 2018 Feb 27:1-10. Epub 2018 Feb 27.

c Faculty of Medicine , University of Rijeka , Rijeka , Croatia.

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. Read More

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http://dx.doi.org/10.1080/10790268.2018.1439432DOI Listing
February 2018
1 Read

Preventive care among primary care patients living with spinal cord injury.

J Spinal Cord Med 2018 Feb 9:1-7. Epub 2018 Feb 9.

a Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital , Ontario , Canada.

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. Read More

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http://dx.doi.org/10.1080/10790268.2018.1432308DOI Listing
February 2018
6 Reads

Autonomic dysreflexia caused by cervical stenosis.

Spinal Cord Ser Cases 2017 29;3:17102. Epub 2017 Dec 29.

Department of Orthopedic Surgery, University of California, San Francisco, CA 94143 USA.

Introduction: Autonomic dysreflexia (AD) is a well-known sequela of high spinal cord injuries (SCI). The characteristic episodic presentation is one of increased sympathetic tone: diaphoresis, hypertension, tachycardia, or reflex bradycardia. The episodes are triggered by visceral sensations and can last days to weeks. Read More

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http://dx.doi.org/10.1038/s41394-017-0018-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5798920PMC
December 2017
3 Reads

Alarming blood pressure changes during routine bladder emptying in a woman with cervical spinal cord injury.

Spinal Cord Ser Cases 2017 28;3:17101. Epub 2017 Dec 28.

International Collaboration on Repair Discoveries, Faculty of Medicine, University of British Columbia, Vancouver, BC V1Y 1T3 Canada.

Introduction: Many individuals with high-level spinal cord injury (SCI) experience secondary conditions such as autonomic dysreflexia (AD), which is a potentially life-threatening condition comprising transient episodes of hypertension up to 300 mmHg. AD may be accompanied by symptoms and signs such as headache, flushing, and sweating. Delay in AD recognition and management is associated with increased incidence of cardiovascular events and disease. Read More

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http://dx.doi.org/10.1038/s41394-017-0022-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5798923PMC
December 2017
7 Reads

Using the autonomic standards to assess orthostatic hypotension in persons with SCI: a case series.

Spinal Cord Ser Cases 2017 6;3:17087. Epub 2017 Dec 6.

Spinal Unit, Centre Calve, Foundation Hopale, Berck-sur-Mer, France.

Introduction: Spinal cord injury (SCI) creates a complex and unique syndrome of medical issues related to disruption of somatic and autonomic pathways. Among these impaired control of blood pressure (BP) can significantly impede patients' activities of daily living. The International Standards for the Assessment of Autonomic Function after SCI (ISAFSCI) is used to document the impact of SCI on resting BP (abnormal if below 90 mmHg) and the presence or absence of orthostatic hypotension (OH), defined as a symptomatic or asymptomatic decrease in BP (>/=20/10 mmHg) upon moving to an upright position. Read More

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http://dx.doi.org/10.1038/s41394-017-0021-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5798922PMC
December 2017
2 Reads

Acute visual loss in a patient with spinal cord injury.

Spinal Cord Ser Cases 2017 14;3:17080. Epub 2017 Nov 14.

2Department of Physical Medicine and Rehabilitation, Medical College of Wisconsin, Milwaukee, WI USA.

Introduction: Patients with spinal cord injury (SCI), especially those with injury at and above T6, are prone to transient episodes of hypertension induced by noxious triggers below the level of SCI, known as autonomic dysreflexia (AD). An uncommonly reported presentation of AD is posterior reversible encephalopathy syndrome (PRES).

Case Presentation: A 50-year-old male with the history of paraplegia from SCI presented with sepsis secondary to baclofen pump and urinary tract infections. Read More

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http://dx.doi.org/10.1038/s41394-017-0010-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5798915PMC
November 2017
10 Reads

Inflammatory Stress Effects on Health and Function After Spinal Cord Injury.

Top Spinal Cord Inj Rehabil 2017 ;23(3):207-217

The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, Florida.

Injury to the spinal cord produces immediate, adaptive inflammatory responses that can exacerbate the initial injury and lead to secondary damage. Thus far, researchers and clinicians have focused on modulating acute inflammation to preserve sensorimotor function. However, this singular approach risks overlooking how chronic inflammation negatively impacts the broader health of persons with a spinal cord injury (SCI). Read More

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http://dx.doi.org/10.1310/sci2303-207DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5562028PMC
August 2018
18 Reads

Improving Sexual Satisfaction in Persons with Spinal Cord Injuries: Collective Wisdom.

Top Spinal Cord Inj Rehabil 2017 ;23(1):57-70

The Sexual Health Network, Inc.

Sexuality is an important part of life, and it is necessary for clinicians to have a specific format in which to address sexual issues with their patients. A systematic approach to working with patients with spinal cord injury (SCI) to improve their sexual functioning and response is presented. Nonjudgmental communication about sexual concerns is followed by a detailed pre- and postinjury medical, psychosocial, and sexual history. Read More

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http://dx.doi.org/10.1310/sci2301-57DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5340510PMC
October 2018
9 Reads

Cardiovascular Physiology and Responses to Sexual Activity in Individuals Living with Spinal Cord Injury.

Top Spinal Cord Inj Rehabil 2017 ;23(1):11-19

International Collaboration On Repair Discoveries, Vancouver, BC, Canada.

Spinal cord injury (SCI) may profoundly impact autonomic function producing a variable degree of dysfunction in cardiovascular, bronchopulmonary, sweating, bladder, bowel, and sexual function. The cardiovascular system is crucially important for sexual function, as it is responsible for blood flow shifts to cavernous and musculoskeletal tissue during sexual activity. This system is prone to 3 main abnormalities after SCI including low resting blood pressure (LRBP), orthostatic hypotension (OH), and autonomic dysreflexia (AD), all of which have important effects on sexual function. Read More

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http://archive.scijournal.com/doi/10.1310/sci2301-11
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http://dx.doi.org/10.1310/sci2301-11DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5340505PMC
October 2018
3 Reads

Cold pressor test in spinal cord injury-revisited.

Spinal Cord 2018 06 20;56(6):528-537. Epub 2017 Dec 20.

International Collaboration on Repair Discoveries (ICORD), Blusson Spinal Cord Centre (BSCC), University of British Columbia, Vancouver, BC, Canada.

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. Read More

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http://dx.doi.org/10.1038/s41393-017-0037-zDOI Listing
June 2018
9 Reads

Cardiovascular Monitoring During Video Urodynamic Studies in Persons With Spinal Cord Injury.

Am J Phys Med Rehabil 2018 Jan;97(1):1-6

From the Department of Rehabilitation Medicine, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea (JAY, YBS, MJS); and Department of Rehabilitation Medicine, Pusan National University School of Medicine, Research Institute of Convergence for Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea (MSK, H-YK).

Objective: The aims of the study were to observe cardiovascular responses during video urodynamic studies and to identify correlations between autonomic dysreflexia events and video urodynamic study findings in spinal cord injuries.

Design: Thirty-four persons with spinal cord injury were enrolled and investigated using continuous cardiovascular monitoring during video urodynamic studies. Associations between cardiovascular responses and video study variables were analyzed. Read More

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http://dx.doi.org/10.1097/PHM.0000000000000839DOI Listing
January 2018
8 Reads

A Community Perspective on Bowel Management and Quality of Life after Spinal Cord Injury: The Influence of Autonomic Dysreflexia.

J Neurotrauma 2018 May 9;35(9):1091-1105. Epub 2018 Feb 9.

1 Department of Biomedical Physiology and Kinesiology, Simon Fraser University , Burnaby, British Columbia, Canada .

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). Read More

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http://dx.doi.org/10.1089/neu.2017.5343DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5908418PMC
May 2018
16 Reads

Prevalence of Autonomic Dysreflexia in Patients with Spinal Cord Injury above T6.

Biomed Res Int 2017 26;2017:2027594. Epub 2017 Oct 26.

Department of Rehabilitation Medicine and Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, 895 Muwang-ro, Iksan, Jeonbuk 54538, Republic of Korea.

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. Read More

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http://dx.doi.org/10.1155/2017/2027594DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5684522PMC
July 2018
4 Reads

Rapamycin Exacerbates Cardiovascular Dysfunction after Complete High-Thoracic Spinal Cord Injury.

J Neurotrauma 2018 Mar 29;35(6):842-853. Epub 2018 Jan 29.

1 Department of Physiology, University of Kentucky , Lexington, Kentucky.

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. Read More

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http://dx.doi.org/10.1089/neu.2017.5184DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5863090PMC
March 2018
10 Reads

Some Autonomic Deficits of Acute or Chronic Cervical Spinal Contusion Reversed by Interim Brainstem Stimulation.

J Neurotrauma 2018 02 21;35(3):560-572. Epub 2017 Dec 21.

Department of Neurological Surgery and The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine , Miami, Florida.

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. Read More

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http://dx.doi.org/10.1089/neu.2017.5123DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6422002PMC
February 2018
7 Reads

Transient Hypertension after Spinal Cord Injury Leads to Cerebrovascular Endothelial Dysfunction and Fibrosis.

J Neurotrauma 2018 02 2;35(3):573-581. Epub 2018 Jan 2.

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

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. For this, iatrogenic urodynamic filling/penile vibrostimulation was completed while measuring beat-by-beat blood pressure and cerebral blood flow (CBF) in patients. Read More

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http://dx.doi.org/10.1089/neu.2017.5188DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6421994PMC
February 2018
15 Reads