What is Neurogenic Shock?

Neurogenic shock is a condition that occurs when blood vessels cease functioning correctly and aren’t able to move enough blood throughout the body. There isn’t any blood loss; however, the blood does not circulate properly. The blood accumulates in blood vessels, and your blood pressure falls dramatically.

The reason for the neurogenic shock is typically a spinal cord injury. When the nerves within the spinal cord have been damaged, they stop transmitting messages to nerves that regulate other body functions. If nerve signals sent to muscles of the blood vessels are cut off, the vessels stop functioning properly.

A blood clot, or stroke, that blocks blood flow may also trigger neurogenic shock. In rare instances, patients suffer from neurogenic shock as a reaction to spinal anesthesia. It could also be an adverse effect of certain medications or a brain-related infection, including meningitis.

Effects and Signs of Neurogenic Shock

Neurogenic shock

The duration of neurogenic shock is usually between 1 and 6 weeks following a spinal cord injury happens. Although it mostly affects the cardiovascular system, it could cause permanent tissue damage if not treated. It is, therefore, essential to recognize symptoms and seek medical care.

In the absence of sympathetic nerves, the blood vessels expand, resulting in a decrease in pressure that circulates blood throughout the body. In the end, cells must fuel adequately with the nutrients and oxygen required for proper body function.

Loss of sympathetic nerves can also lead to blood accumulating in the veins in the limbs. Instead of flowing back towards the heart, it can collect in the arms or legs, causing a negative cycle in which less and lesser blood flows through the body.

Common signs Common symptoms  of neurogenic shock are:

  • Hypotension: Low blood pressure (lower than 90 mm Hg for systolic blood pressure or 60mm Hg diastolic).
  • Bradycardia: slower than the normal heartbeat (below 60 beats per minute).
  • The body’s temperature is not properly controlled. Initially, vasodilation and the formation of blood pools in those areas (arms and legs) can result in dry, warm skin. However, over time hypothermia could be a result of heat loss.

The three symptoms could manifest themselves in various ways, such as:

To avoid damage to the tissue due to insufficient circulation, the signs of neurogenic shock must be dealt with promptly. In the next section, we’ll look at ways to treat it.

What Causes Neurogenic Shock

Neurogenic shock typically occurs in the aftermath of spinal cord injuries, which disrupt the infiltration (the source of energy) of the sympathetic nervous system. The sympathetic nervous system triggers your body’s “fight or fight or” response. When activated, the body is placed in high alert mode: blood vessels contract (constrict), and the heart rate and blood pressure rise.

The parasympathetic system can block the sympathetic nervous system, which is responsible for your “rest as well as digest” functions. When activated, blood vessels grow (dilate), heart rate and blood pressure drop, and digestion gets activated.

Both systems are crucial for proper functioning. Typically, the parasympathetic and sympathetic nervous systems conflict with the course of the day based on the circumstance to meet the body’s demands.

When a person experiences neurogenic shock due to an injury to the spinal cord, it is a loss in sympathetic neuralgia that causes unopposed parasympathetic stimulation. In this way, the body’s relaxation reaction can take over completely.

Diagnose of Neurogenic Shock

To diagnose the condition, doctors first conduct a physical exam for other symptoms and examine blood pressure levels. There are a variety of tests that doctors employ to determine the degree of damage that led to neurogenic shock.

CT scan

The CT scan employs images of X-rays to show images of your body. If you suffer from an injury to your spine, CT scans can help determine your injury’s seriousness. They can also assist doctors in identifying the possible injuries to the internal organs or damage that may cause.

An MRI Scan

An MRI or imaging scan is used to reveal the internal structures within your body, like your spine. It is a great way to identify any problems with your spinal column. With an examination of the symptoms you are experiencing, your doctor may utilize the MRI scan to determine the cause of your lower back discomfort and neurogenic shock.

Urinary catheter

Doctors may also utilize the urine catheter to gauge your urine volume. In the case of certain spine injuries, possible that you could not be able to urinate by yourself or suffer due to constipation. By testing your urine, the doctors can assist in identifying any symptoms of infection.

The Treatment of the Neurogenic Shock

Neurogenic shock may cause irreparable harm if it is not treated promptly. Treatment options are designed to help stabilize the patient and stop any damage or injury that may occur in the future.

The doctor will put you in a position to stop any further injury. They will then provide you with intravenous fluids to control your blood pressure. If your blood pressure gets low, you could receive vasopressors or medications that help tighten your blood vessels and thus increase the pressure. The most commonly used vasopressors are:

  • Norepinephrine
  • Epinephrine
  • Dopamine
  • Vasopressin

Additionally, if you are experiencing a slower heartbeat, your doctor might prescribe atropine. This medication can help ensure that your heartbeat is regular.

Neurogenic Shock Vs. Spinal Shock.

Neurogenic shock and spinal shock are two distinct disorders that are frequently confused with one another because they both develop following an injury to the spinal cord. In addition, they may be characterized by symptoms like bradycardia and hypotension.

As opposed to the neurogenic shock (which typically occurs at the T6 point of injury or greater), the spinal shock could be triggered by injuries to any area in the spine.

Neurogenic shock is an interruption in the sympathetic nervous system that alters blood vessels’ tone. With no sympathetic activity, blood can’t effectively circulate throughout the body, resulting in a lower heart rate, lower blood tension, and temperature imbalance.

The reverse is true for spinal shock. It causes temporary loss of sensory, motor, and reflex functions beneath the level of injury. It is caused by swelling and inflammation within the spine’s nerves, which limits blood flow below the point of injury. After the spinal cord is stabilized and swelling is reduced, the patient may slowly get back some sensations, reflexes, or motor controls. It will all be based on the severity of the injury to the spinal cord.

Preventing the development of neurogenic shock

There isn’t a definitive method to avoid neurogenic shock. However, being aware of the potential for spinal cord injuries can assist. These precautions might include the following:

  • Wearing a helmet while participating in any sports can cause head injury, for example, skiing, cycling, or riding a motorbike.
  • Always wearing a seatbelt in the vehicle.
  • Avoid driving when under the influence of alcohol or other drugs.
  • Beware of getting in a vehicle with a driver under the influence of alcohol or other drugs.
  • taking precautions to avoid falling at home to prevent falls
  • Keeping firearms secure and unloaded to avoid accidents

Outlook

The likelihood of a neurogenic shock could be based on the extent of the spinal cord injury and how people react to treatment.

Some people may experience symptoms of neurogenic shock that last for four weeks.

If not treated, Neurogenic shock could be fatal; therefore, immediate medical attention is crucial.

Summary

The condition can develop after an injury to the spinal cord and can even be fatal.

Trauma or injury on the spine could result in nerve damage that alters how the body functions to manage blood pressure, heart rate, and blood flow. It could affect circulation, resulting in the absence of the flow of nutrients and oxygen to vital organs.

Patients should seek medical attention immediately when they suspect a spinal cord injury or any indications of neurogenic shock, including:

  • nausea
  • faintness or dizziness
  • chest pain
  • Inadequate temperature regulation

The future of those suffering from neurogenic shock could depend on the degree of the spinal cord injury. Doctors can treat neurogenic shock using vasopressors, IV fluids, and surgery.

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