Case study 240 - Autonomic Dysreflexia explained by neurosurgeon Dr. Betsy Grunch
Description: Case study 240 - Autonomic Dysreflexia
A patient with a spinal cord injury above T6 suddenly develops a pounding headache, flushing above the level of the injury, sweating, and severe hypertension.
This is autonomic dysreflexia—a potentially life-threatening medical emergency.
Here’s what’s happening:
🧠 A painful or irritating stimulus below the level of the spinal cord injury (most commonly a distended bladder, bowel impaction, tight clothing, or a skin injury) triggers an exaggerated sympathetic response. Because the spinal cord injury blocks normal signals from the brain, the body can’t appropriately regulate the blood pressure, causing it to rise rapidly.
Common symptoms include:
• Sudden, severe headache
• Markedly elevated blood pressure
• Flushing and sweating above the injury
• Goosebumps below the injury
• Nasal congestion
• Slow heart rate (though it can vary)
Immediate treatment:
✔️ Sit the patient upright.
✔️ Loosen any tight clothing.
✔️ Find and remove the trigger—check the bladder first, then the bowel and skin.
✔️ If the blood pressure remains dangerously elevated after the trigger is addressed, antihypertensive medication may be needed.
Autonomic dysreflexia is time-sensitive. Rapid recognition and treatment can prevent serious complications such as stroke, seizure, cardiac events, or death.
Have you ever encountered autonomic dysreflexia in your practice?
#CaseStudy240 #AutonomicDysreflexia #SpinalCordInjury #sundaycasestudy #ladyspinedoc Close description
A patient with a spinal cord injury above T6 suddenly develops a pounding headache, flushing above the level of the injury, sweating, and severe hypertension.
This is autonomic dysreflexia—a potentially life-threatening medical emergency.
Here’s what’s happening:
🧠 A painful or irritating stimulus below the level of the spinal cord injury (most commonly a distended bladder, bowel impaction, tight clothing, or a skin injury) triggers an exaggerated sympathetic response. Because the spinal cord injury blocks normal signals from the brain, the body can’t appropriately regulate the blood pressure, causing it to rise rapidly.
Common symptoms include:
• Sudden, severe headache
• Markedly elevated blood pressure
• Flushing and sweating above the injury
• Goosebumps below the injury
• Nasal congestion
• Slow heart rate (though it can vary)
Immediate treatment:
✔️ Sit the patient upright.
✔️ Loosen any tight clothing.
✔️ Find and remove the trigger—check the bladder first, then the bowel and skin.
✔️ If the blood pressure remains dangerously elevated after the trigger is addressed, antihypertensive medication may be needed.
Autonomic dysreflexia is time-sensitive. Rapid recognition and treatment can prevent serious complications such as stroke, seizure, cardiac events, or death.
Have you ever encountered autonomic dysreflexia in your practice?
#CaseStudy240 #AutonomicDysreflexia #SpinalCordInjury #sundaycasestudy #ladyspinedoc Close description