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JAAD Case Rep 2020 Jul 19;6(7):640-642. Epub 2020 May 19.

Department of Dermatology, University of California, Irvine, California.

Int J Gynaecol Obstet 2020 Jun 29. Epub 2020 Jun 29.

First Department of Obstetrics and Gynecology, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Postnatally developed autonomic dysreflexia (AD) can be a rare manifestation of breastfeeding.[1] Although antepartum AD and postpartum exacerbations have been previously reported in the literature, postnatally developed AD triggered by breastfeeding is an extremely rare occurrence. To the best of our knowledge, the present study reports the first non-plegic post-traumatic syringomyelia patient with postnatally developed AD triggered by breastfeeding. Read More

Front Cell Neurosci 2020 18;14:127. Epub 2020 May 18.

Division of Genetics and Development, Krembil Research Institute, University Health Network, Toronto, ON, Canada.

Traumatic spinal cord injury (SCI) impedes signal transmission by disrupting both the local neurons and their surrounding synaptic connections. Although the majority of SCI patients retain spared neural tissue at the injury site, they predominantly suffer from complete autonomic and sensorimotor dysfunction. While there have been significant advances in the characterization of the spared neural tissue following SCI, the functional role of injury-induced interneuronal plasticity remains elusive. Read More

World J Gastroenterol 2020 May;26(20):2479-2497

Joint Veteran Center, Scientific Department, Army Medical Center, Rome 00184, Italy.

The aim of this review is to offer dietary advice for individuals with spinal cord injury (SCI) and neurogenic bowel dysfunction. With this in mind, we consider health conditions that are dependent on the level of lesion including skeletal muscle atrophy, autonomic dysreflexia and neurogenic bladder. In addition, SCI is often associated with a sedentary lifestyle, which increases risk for osteoporosis and diseases associated with chronic low-grade inflammation, including cardiovascular and chronic kidney diseases. Read More

J Neurotrauma 2020 Jun 9. Epub 2020 Jun 9.

University of Louisville, Anatomical Sciences & Neurobiology, 500 S. Preston St., HSC, Bldg. A, Room 916, Louisville, Kentucky, United States, 40292;

Bowel dysfunction after chronic spinal cord injury (SCI) is a common source of morbidity and rehospitalization. Typical complications include constipation, fecal impaction, incontinence, abdominal distention, autonomic dysreflexia, and the necessity of interventions (i.e. Read More

Spinal Cord Ser Cases 2020 Jun 8;6(1):47. Epub 2020 Jun 8.

Department of Urology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.

Introduction: Bladder rupture in patients with indwelling urethral catheters is rare. Herein, we describe two spinal cord injured (SCI) patients with neurogenic bladder dysfunction managed with chronic indwelling catheters who presented with extraperitoneal bladder rupture related to bladder instillation. One case was during continuous bladder irrigation for hematuria, the other during routine cystography. Read More

J Spinal Cord Med 2020 May 12:1-5. Epub 2020 May 12.

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

The current diagnostic criteria of autonomic dysreflexia (AD) is based solely on systolic blood pressure (SBP) increases from baseline without regard to changes in diastolic blood pressure (DBP). During urodynamics in persons with SCI at or above the sixth thoracic level (T6), we evaluated diastolic blood pressure (DBP) changes related with AD episodes. Retrospective review of blood pressures recorded during urodynamics. Read More

Obstet Gynecol 2020 May;135(5):e230-e236

Approximately 17,730 new spinal cord injuries (SCIs) occur per year in the United States. Effective rehabilitation and modern reproductive technology may increase the number of these patients considering pregnancy. Obstetrician-gynecologists and other obstetric care professionals who care for such patients should be familiar with problems related to SCIs that may occur throughout pregnancy and during the postpartum period. Read More

Obstet Gynecol 2020 May;135(5):1247-1249

Approximately 17,730 new spinal cord injuries (SCIs) occur per year in the United States. Effective rehabilitation and modern reproductive technology may increase the number of these patients considering pregnancy. Obstetrician-gynecologists and other obstetric care professionals who care for such patients should be familiar with problems related to SCIs that may occur throughout pregnancy and during the postpartum period. Read More

Spinal Cord 2020 Apr 8. Epub 2020 Apr 8.

Department of Pediatrics, College of Medicine, Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University, College Station, TX, USA.

Study Design: It is a qualitative study.

Objectives: To develop the items and support content validity for the Pediatric Quality of Life Inventory™ (PedsQL™) Spinal Cord Injury Module for youth and emerging adults with spinal cord injury (SCI).

Setting: Community and children's hospital. Read More

Scand J Urol 2020 Apr 9;54(2):155-161. Epub 2020 Mar 9.

Department NVS, Division of Clinical Geriatrics, Karolinska Institute, Stockholm, Sweden.

To examine symptomatic urinary tract infections (UTI) in a regional prevalence group of patients with traumatic spinal cord injury (SCI), to assess risk factors for recurring infections and to identify a high-risk sub-population for frequently recurring and severe febrile UTIs. Four hundred and twelve patients who attended a yearly check-up at the Spinalis SCI clinic were included. A regional programme for neurogenic bladder dysfunction was applied, including S-creatinine and S-cystatin-C, urine culture, residual urine, ultrasound of kidneys, urodynamic studies and a questionnaire regarding complications during the preceding year. Read More

Spinal Cord Ser Cases 2020 Mar 3;6(1):12. Epub 2020 Mar 3.

Spinal Cord Injury and Disorders Center, Hunter Holmes McGuire VAMC, 1201 Broad Rock Boulevard, Richmond, VA, 23249, USA.

Introduction: Spinal cord injury (SCI) may cause impairments of the motor, sensory, and autonomic nervous systems, which result in adverse changes in body composition and cardiovascular health. Functional electrical stimulation (FES) cycling may provide an effective alternative approach to perform exercise and improve cardiovascular health after SCI. Persons with an injury at or above T6 level are at high risk of developing a life-threatening complication of autonomic dysreflexia (AD). Read More

IEEE J Transl Eng Health Med 2020 20;8:2800108. Epub 2020 Jan 20.

1Weldon School of Biomedical EngineeringPurdue UniversityWest LafayetteIN47907USA.

Objective: Autonomic Dysreflexia (AD) is a potentially life-threatening syndrome which occurs in individuals with higher level spinal cord injuries (SCI). AD is caused by triggers which can lead to rapid escalation of pathophysiological responses and if the trigger is not removed, AD can be fatal. There is currently no objective, non-invasive and accurate monitoring system available to automatically detect the onset of AD symptoms in real time in a non-clinical setting. Read More

Exp Neurol 2020 May 7;327:113235. Epub 2020 Feb 7.

International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada; Department of Medicine, Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, Canada; GF Strong Rehabilitation Center, Vancouver Coastal Health, Vancouver, Canada. Electronic address:

Spinal cord injury (SCI) disrupts the supraspinal vasomotor pathways to sympathetic preganglionic neurons (SPNs) leading to impaired blood pressure (BP) control that often results in episodes of autonomic dysreflexia and orthostatic hypotension. The physiological cardiovascular consequences of SCI are largely attributed to the plastic changes in spinal SPNs induced by their partial deafferentation. While multiple studies have investigated the morphological changes in SPNs following SCI with contrasting reports. Read More

J Spinal Cord Med 2020 Feb 11:1-4. Epub 2020 Feb 11.

Physical Medicine and Rehabilitation, Baylor Scott and White Institute for Rehabilitation, Dallas, Texas, USA.

Takotsubo cardiomyopathy (TC) is a transient stress-induced cardiomyopathy with left ventricular dysfunction of unknown etiology. A well accepted theory for the pathophysiology of TC is attributed to a massive catecholamine release [1]. This case report will review a chronic tetraplegia patient who was diagnosed with TC after a severe episode of autonomic dysreflexia (AD). Read More

Med Clin North Am 2020 Mar 16;104(2):263-278. Epub 2019 Dec 16.

Spinal Cord Injuries and Disorders Center, Louis Stokes Cleveland VA Medical Center, 10701 East Boulevard, 128(W), Cleveland, OH 44106, USA; Department of Physical Medicine and Rehabilitation, Case Western Reserve University, MetroHealth System, Old Brooklyn Campus, 4229 Pearl Road, Cleveland, OH 44109, USA. Electronic address:

Individuals with spinal cord injuries or disorders (SCI/D), whether of traumatic or nontraumatic cause, require multidisciplinary management by their care team to achieve optimal health outcomes. SCI/D is relatively rare in the general population and primary care providers (PCPs) may not have extensive experience managing people with these disorders. Spinal cord injuries, impair the body's autonomic and biomechanical performance by interrupting the communications to and from major bodily systems. Read More

Continuum (Minneap Minn) 2020 Feb;26(1):138-153

Purpose Of Review: Autonomic hyperactivity is a relatively common consequence of severe acute brain injury and can also be seen with spinal cord and peripheral nerve disorders. This article reviews basic pathophysiologic concepts regarding autonomic hyperactivity, its various forms of clinical presentation, and practical management considerations.

Recent Findings: Paroxysmal sympathetic hyperactivity is most common after traumatic brain injury but can also occur after other forms of severe acute diffuse or multifocal brain injury. Read More

Iran J Public Health 2019 Dec;48(12):2260-2269

Brain and Spinal Cord Injury Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Background: The goal of this study was to determine hazard rate of death rate and the causes of death in Iranian patients with Traumatic spinal cord injury (TSCI).

Methods: Overall, 1024 patients with chronic traumatic spinal cord injury referred to Brain and Spinal Injury Research Center, Tehran University of Medical Sciences, Tehran, Iran from Jan 2013-2017 were enrolled. Epidemiological and neurological data, along with secondary complications were recorded for all participants. Read More

J Neurotrauma 2020 May 1;37(9):1149-1155. Epub 2020 Apr 1.

Erik Jonsson School of Engineering and Computer Science, The University of Texas at Dallas, Richardson, Texas, USA.

Pairing vagus nerve stimulation (VNS) with rehabilitation has emerged as a potential strategy to enhance plasticity and improve recovery in a range of neurological disorders. A recent study highlights the therapeutic promise of VNS in promoting motor recovery after spinal cord injury (SCI). We investigated the safety of acute VNS in a rat model of chronic SCI. Read More

J Neurosci 2020 Feb 2;40(6):1248-1264. Epub 2020 Jan 2.

Marion Murray Spinal Cord Research Center, Department of Neurobiology & Anatomy, Drexel University College of Medicine, Philadelphia, Pennsylvania 19129

Cardiovascular dysfunction often occurs after high-level spinal cord injury. Disrupting supraspinal vasomotor pathways affects basal hemodynamics and contributes to the development of autonomic dysreflexia (AD). Transplantation of early-stage neurons to the injured cord may reconstruct the descending projections to enhance cardiovascular performance. Read More

Spinal Cord 2020 Apr 19;58(4):391-401. Epub 2019 Dec 19.

International Collaboration on Repair Discoveries (ICORD), University of British Columbia, 818 West 10th Avenue, Vancouver, BC, V5Z 1M9, Canada.

Study Design: A narrative review describing various components of sexual dysfunction in men with spinal cord injury (SCI), as well as addressing potential therapeutic approaches.

Objectives: Restoration of sexual function is considered one of the most important health priorities for individuals with SCI. The purpose of this review is to provide information regarding the factors that are less appreciated when considering changes to sexual function in men with SCI. Read More

Emerg Nurse 2020 01 6;28(1):22-27. Epub 2019 Dec 6.

Faculty of Life Sciences and Education, University of South Wales, Pontypridd, Wales.

Autonomic dysreflexia is a potentially life-threatening condition that affects patients with a spinal cord injury at the level of T6 or above. It is characterised by uncontrolled elevation of systolic blood pressure of more than 20mmHg, which may occur alongside bradycardia. This article explains the pathophysiology of autonomic dysreflexia, alongside its causes, signs and symptoms. Read More

J Spinal Cord Med 2019 Dec 9:1-4. Epub 2019 Dec 9.

Center for Pain Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands.

Episodic attacks of autonomic dysreflexia (AD) are regularly experienced by patients with a spinal cord injury (SCI) on T6 or higher levels. The episodes can result in a pounding headache, flushing, blurred vision, anxiety, a stroke, posturing, hyperthermia, retinal bleeding, seizures, myocardial ischemia, cardiac arrhythmias, and death. The observed associated bradycardia is explained as a baroreceptor reflex response to the high blood pressure. Read More

J Spinal Cord Med 2019 Dec 6:1-4. Epub 2019 Dec 6.

Center for Neuroscience and Neurological Recovery, Methodist Rehabilitation Center, Jackson, Mississippi, USA.

Functional electric stimulation (FES) cycling is a commonly used therapeutic exercise modality after spinal cord injury (SCI); however, additional precautions must be taken in certain situations. The purpose of this study was to develop and apply a safety monitoring protocol for autonomic dysreflexia (AD) during FES cycling and to determine if an interval-FES cycling program can be safe and beneficial to an individual with cervical SCI, a history of AD, and a non-dependent cardiac pacemaker.The participant was a 36-year-old male with C6 AIS-C SCI sustained 9 years earlier, intermittent AD, and implanted cardiac pacemaker. Read More

Front Cell Neurosci 2019 8;13:505. Epub 2019 Nov 8.

Department of Physiology, Spinal Cord and Brain Injury Research Center, University of Kentucky, Lexington, KY, United States.

Traumatic spinal cord injury (SCI) leads to disruption of sensory, motor and autonomic function, and triggers structural, physiological and biochemical changes that cause reorganization of existing circuits that affect functional recovery. Propriospinal neurons (PN) appear to be very plastic within the inhibitory microenvironment of the injured spinal cord by forming compensatory circuits that aid in relaying information across the lesion site and, thus, are being investigated for their potential to promote locomotor recovery after experimental SCI. Yet the role of PN plasticity in autonomic dysfunction is not well characterized, notably, the disruption of supraspinal modulatory signals to spinal sympathetic neurons after SCI at the sixth thoracic spinal segment or above resulting in autonomic dysreflexia (AD). Read More

Am J Physiol Heart Circ Physiol 2020 02 27;318(2):H223-H237. Epub 2019 Nov 27.

Department of Pharmacology and Toxicology, Michigan State University, East Lansing, Michigan.

Complications associated with spinal cord injury (SCI) result from unregulated reflexes below the lesion level. Understanding neurotransmission distal to the SCI could improve quality of life by mitigating complications. The long-term impact of SCI on neurovascular transmission is poorly understood, but reduced sympathetic activity below the site of SCI enhances arterial neurotransmission (1). Read More

Spinal Cord 2020 Apr 25;58(4):430-440. Epub 2019 Nov 25.

Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada.

Study Design: Clinical trial.

Objective: Spinal cord injury (SCI) impacts autonomic function and bowel management. Bowel care is a potential trigger for autonomic dysreflexia (AD; paroxysmal hypertension elicited by sensory stimuli below the level of lesion). Read More

Rev Esp Anestesiol Reanim 2019 Dec 20;66(10):497-505. Epub 2019 Nov 20.

Servicio de Anestesiología y Reanimación, Hospital Clínic, Barcelona, España.

Background: The diaphragm pacemaker (DP) has proven its utility in replacing mechanical ventilation in patients with chronic spinal cord injury (SCI) and amyotrophic lateral sclerosis (ALS). The DP improves patient quality of life and reduces morbidity and mortality and their associated health care costs. The anesthetic management of these patients and the particularities of the surgical procedure are challenging. Read More

J Neurosci 2020 01 21;40(2):478-492. Epub 2019 Nov 21.

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

Spinal cord injury (SCI) disrupts critical physiological systems, including the cardiovascular and immune system. Plasticity of spinal circuits below the injury results in abnormal, heightened sympathetic responses, such as extreme, sudden hypertension that hallmarks life-threatening autonomic dysreflexia. Moreover, such sympathetic hyperreflexia detrimentally impacts other effector organs, including the spleen, resulting in spinal cord injury-induced immunodeficiency. Read More

Physiol Behav 2020 01 16;213:112742. Epub 2019 Nov 16.

International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada; Department of Medicine, Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, Canada; GF Strong Rehabilitation Centre, Vancouver Coastal Health, Vancouver, Canada. Electronic address:

This study: 1) compared cognitive functioning between individuals with chronic (>1 year) spinal cord injury (SCI) and non-injured controls and, 2) assessed associations between symptoms of autonomic dysreflexia and orthostatic hypotension with cognitive functioning in SCI participants with a history of unstable blood pressure (BP). Thirty-two individuals with SCI (C4-L2, American Spinal Injury Association Impairment Scale A-D) and thirty age, sex-matched non-injured controls participated in this study. Participants completed a motor-free neuropsychological test battery assessing 1) memory, 2) attention/concentration/psychomotor speed and, 3) executive function. Read More

Neurourol Urodyn 2020 01 18;39(1):376-381. Epub 2019 Nov 18.

Kessler Institute for Rehabilitation, West Orange, New Jersey.

Aims: To obtain objective evidence for the time to onset of action for intravesical lidocaine utilizing exaggerated sympathetic blood-pressure responsiveness in patients with spinal cord injuries (SCI).

Methods: This prospective observational cohort study analyzed blood pressure responses in individuals with SCI at or above T6 who did (lidocaine-instillation group) or did not (control group) receive 10 ml of 2% lidocaine gel instilled through their catheters before routine suprapubic catheter change. Care was taken to minimize any potentially confounding position change or catheter manipulation. Read More

Exp Neurol 2020 Jan 31;323:113083. Epub 2019 Oct 31.

Department of Physiology, University of Kentucky, Lexington, KY 40536, USA; Spinal Cord and Brain Injury Research Center (SCoBIRC), University of Kentucky, B 471 Biomedical & Biological Research Building (BBSRB), 741 South Limestone Street, Lexington, KY 40536-0509, USA. Electronic address:

Spinal cord injury (SCI) can have profound effects on the autonomic and cardiovascular systems, notably with injuries above high-thoracic levels that result in the development of autonomic dysreflexia (AD) characterized by volatile hypertension in response to exaggerated sympathetic reflexes triggered by afferent stimulation below the injury level. Pathophysiological changes associated with the development of AD include sprouting of both nociceptive afferents and ascending propriospinal 'relay' neurons below the injury, as well as dynamic changes in synaptic inputs onto sympathetic preganglionic neurons. However, it remains uncertain whether synapse formation between sprouted c-fibers and propriospinal neurons contributes to the development of exaggerated sympathetic reflexes produced during AD. Read More

Curr Pain Headache Rep 2019 Aug 27;23(11):80. Epub 2019 Aug 27.

Department of Neurology, Mayo Clinic College of Medicine, 200 First St. SW, Floor 8, Rochester, MN, 55905, USA.

A patient presenting with marked elevation in blood pressure and concurrent headache often presents a diagnostic challenge for even the most seasoned clinician. When marked hypertension and headache occur in a patient with a history of upper spinal cord injury, the patient should be presumed to have autonomic dysreflexia until proven otherwise. Autonomic dysreflexia can at times trigger headaches, hypertension, and variations in pulse, as well other autonomic signs and symptoms. Read More

J Spinal Cord Med 2019 Aug 12:1-7. Epub 2019 Aug 12.

a Department of Rehabilitation, First Faculty of Medicine, Medical University of Warsaw , Warsaw , Poland.

Autonomic dysreflexia (AD) is an emergency condition typical for individuals with spinal cord injury (SCI). Adequate health professionals' knowledge of AD is important for the effective and safe rehabilitation of persons with SCI. The purpose of the study is to assess the knowledge of AD in undergraduate and postgraduate physiotherapists. Read More

Neurology 2019 08 15;93(8):339-345. Epub 2019 Jul 15.

Spinal Cord 2019 Dec 9;57(12):1040-1047. Epub 2019 Jul 9.

Department of Urologic Sciences, Principal Investigator International Collaboration on Repair Discover (ICORD), Peter Wall Institute of Advanced Studies Scholar, University of British Columbia, Vancouver, Canada.

Study Design: Descriptive study OBJECTIVES: Urinary tract infections (UTIs) are one of the most frequent types of infections following spinal cord injury (SCI). Here we assess the relationship between frequency of UTIs and activity level/overall quality of life (QOL) measures, determine the frequency of temporally associated conditions associated with UTI and identify factors associated with frequent UTIs.

Setting: Canada METHODS: The Spinal Cord Injury Community Survey was developed to assess major dimensions of community living and health outcomes in persons with chronic SCI in Canada. Read More

Colorectal Dis 2019 Dec 19;21(12):1415-1420. Epub 2019 Jul 19.

Department of Colorectal Surgery, Prince of Wales Hospital, Sydney, New South Wales, Australia.

Aim: The formation of a diverting stoma of the bowel in patients with spinal cord injury (SCI) is a useful option in managing problems associated with prolonged bowel care, pressure ulcers and neurogenic bowel. This descriptive study examines surgical outcomes and the effect on an individual's health-related quality of life (HrQoL) in this complex group of patients.

Methods: Data were retrospectively collected in all patients with SCI who underwent a diverting stoma at Prince of Wales Hospital, Sydney, between January 2013 and January 2018 via a self-report questionnaire developed specifically for the study. Read More

Spinal Cord 2019 Dec 19;57(12):1057-1063. Epub 2019 Jun 19.

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

Study Design: Cross-sectional.

Objective: To examine the relationship between arterial stiffness and daily fluctuations in blood pressure (BP) owing to hypotensive events and autonomic dysreflexia (AD) in individuals with a T6 and above spinal cord injury (SCI).

Setting: University-based laboratory in Vancouver, BC, Canada. Read More

BMJ Case Rep 2019 Jun 11;12(6). Epub 2019 Jun 11.

Department of Radiology, Barts Health NHS Trust, London, UK.

Spinal cord injury (SCI) is associated with a range of secondary health issues. Altered neurological function can complicate diagnosis, which may have serious consequences. Here we present the case of a tetraplegic person presenting with confusion and bradycardia. Read More

J Int Med Res 2019 Jul 12;47(7):3394-3399. Epub 2019 Jun 12.

Department of Rehabilitation Medicine and Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Republic of Korea.

Cureus 2019 Mar 20;11(3):e4285. Epub 2019 Mar 20.

Neurology, University of Missouri, Columbia, USA.

Reversible cerebral vasoconstriction syndrome (RCVS) is a rare neurological condition that typically presents with a sudden-onset thunderclap headache associated with or without focal neurological deficits. The diagnosis is established by the presence of reversible segmental or diffuse cerebral vasoconstriction on diagnostic cerebral angiogram. Autonomic dysreflexia is a known complication resulting from spinal cord injury. Read More

J Spinal Cord Med 2019 May 29:1-5. Epub 2019 May 29.

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

Individuals with spinal cord injury (SCI) suffering from autonomic dysreflexia (AD) due to neurogenic detrusor overactivity (NDO) can effectively be treated with intradetrusor onabotulinumtoxinA. We present a complex case to highlight the treatment's potential limitations to ameliorate AD and improve lower urinary tract (LUT) function in this population. A 46-year old man, who was relying on an indwelling urethral catheter for bladder emptying due to severely impaired hand function following a SCI (C5, AIS B) sustained 30 years ago, underwent intradetrusor onabotulinumtoxinA injections for treatment of refractory NDO and associated AD. Read More

J Spinal Cord Med 2019 May 29:1-7. Epub 2019 May 29.

d Department of Physical Medicine and Rehabilitation , University of British Columbia , Vancouver , BC , Canada.

Autonomic dysreflexia (AD) is a complex syndrome seen in patients with spinal cord injuries (SCI) and can be life-threatening with a significant negative impact on the health of the individual. Posterior reversible encephalopathy syndrome (PRES) is thought to be caused, in part, by rapid elevations in blood pressure; leading to posterior cerebral circulatory edema. This can result in seizures, blindness and can progress to fatal intracranial hemorrhages. Read More

Am J Hypertens 2019 09;32(10):938-944

Spinal Cord Injury Research, James J Peters VA Medical Center, Bronx, New York, USA.

Background: To determine the degree of blood pressure instability over a 30-day home observation in participants with spinal cord injury grouped by level of injury pertaining to cardiovascular autonomic regulation.

Methods: This is an observational study completed at the Kessler Foundation and James J. Peters Veterans Medical Center. Read More

Int J Mol Sci 2019 May 18;20(10). Epub 2019 May 18.

International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC V5Z 1M9, Canada.

Cognitive impairment following spinal cord injury (SCI) has received considerable attention in recent years. Among the various systemic effects of SCI that contribute towards cognitive decline in this population, cardiovascular dysfunction is arguably one of the most significant. The majority of individuals with a cervical or upper-thoracic SCI commonly experience conditions called orthostatic hypotension and autonomic dysreflexia, which are characterized by dangerous fluctuations in systemic blood pressure (BP). Read More

Am J Physiol Heart Circ Physiol 2019 06 15;316(6):H1332-H1340. Epub 2019 Mar 15.

Department of Emergency Medicine, Wayne State University School of Medicine , Detroit, Michigan.

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 predominant 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

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

PM R 2019 04 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

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

BMJ Open 2018 11 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