Neurogenic shock can occur if a spinal cord injury causes nerve damage and a sudden drop in blood pressure. Neurogenic shock is a medical emergency, and the person will need treatment straight away.

Neurogenic shock occurs when damage to the nervous system makes it difficult for the body to regulate heart rate, blood pressure, and temperature.

A spinal cord injury can damage the nerves that control how widely the blood vessels dilate. This can lead to the blood vessels dilating too much, causing a drop in blood pressure and blood flow.

This change in blood flow can prevent oxygen and nutrients from reaching vital organs in the body.

This article discusses the symptoms, diagnosis, and treatment of neurogenic shock. It also looks at living with a spinal cord injury.

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Neurogenic shock is a life threatening condition that can occur after a spinal cord injury.

A neurogenic condition is one that relates to the nervous system. Shock is a severe condition involving a sudden drop in blood pressure, which reduces the amount of oxygen reaching vital organs.

A spinal cord injury can cause damage to the nerves that control blood pressure, heart rate, and temperature. These are essential for regulating normal function in the body.

The disruption to the nervous system results in:

These effects can lead to a lack of oxygen and nutrients reaching vital organs, which can be fatal without treatment.

Symptoms of neurogenic shock may occur after a spinal cord injury, and they include:

  • low blood pressure, which may make people feel faint or dizzy
  • slow heart rate
  • flushed, warm skin
  • inability to regulate body temperature

If a person has any of these symptoms after a spinal injury, they will need immediate medical attention.

The most common cause of neurogenic shock is a spinal cord injury. This may occur when a person injures their back or neck, such as during a car crash or a fall.

Neurogenic shock occurs following 19.3% of injuries affecting the cervical spine and 7% of those affecting the thoracic spine.

Other, less common causes of neurogenic shock include:

Doctors typically diagnose neurogenic shock by assessing the person’s symptoms and carrying out physical examinations and tests to check for a spinal cord injury.

During this process, they will keep the person immobile to prevent any further damage to the spine.

Doctors will also need to differentiate neurogenic shock from other types of shock, such as hypovolemic shock.

Hypovolemic shock happens due to severe blood loss and causes a fast heart rate or spinal shock, which results in a loss of reflexes and limp muscles.

Doctors will monitor blood pressure and heart rate to check for neurogenic shock. Although there are no clear guidelines, research suggests that the following readings indicate neurogenic shock:

  • systolic blood pressure below 90 millimeters of mercury (mm Hg)
  • heart rate lower than 80 beats per minute (bpm)

Doctors may carry out a range of tests to examine the spinal cord for injury. These may include the following:

CT scan

A CT scan uses computerized imaging to provide images of a person’s internal structures.

Doctors can use it to look at the spinal cord and identify the exact location and extent of any injury.

This scan can also highlight any other issues, such as blood clots.

MRI scan

An MRI scan uses a magnetic field and radio waves to take an image of the spine. This can help doctors identify any abnormalities within the spine, such as herniated disks.

Urinary catheter

Doctors may use a urinary catheter to check spinal cord function. A urinary catheter is a tube that inserts into the bladder and collects urine into a drainage bag.

Spinal cord injuries can affect the nerves that help control bladder function, which can lead to changes in the ability to urinate.

For instance, people may lose bladder control or be unable to empty the bladder as usual. Doctors may also test the urine for any urinary tract infections.

The treatment for neurogenic shock may involve:

  • Immobilizing the spine: Doctors may keep the person securely in place to prevent any further injury to the spinal cord.
  • IV fluids: Doctors can treat low blood pressure with IV fluids resuscitation. This helps blood circulate as normal and delivers oxygen to the organs.
  • Vasopressors: This type of medication causes blood vessels to contract, increasing blood pressure.
  • Other medications: Doctors may use medications such as atropine to increase a person’s heart rate.
  • Surgery: This may be necessary to decompress the spine or treat a spinal injury.

There is no definite way to prevent neurogenic shock, but taking precautions to help prevent spinal cord injuries may help. These precautions may include:

  • wearing a helmet during any activities that may cause a head injury, such as cycling, skiing, or riding a motorcycle
  • always wearing a seatbelt when in a car
  • avoiding driving under the influence of alcohol or drugs
  • avoiding getting into a car with a driver under the influence of alcohol or drugs
  • taking steps to prevent falls in the home
  • keeping any firearms locked away and unloaded to prevent accidents

The outlook for neurogenic shock may depend on the severity of the spinal cord injury and how well people respond to treatment.

People may have symptoms of neurogenic shock for up to 4–5 weeks.

Without treatment, neurogenic shock can be fatal, so immediate medical attention is vital.

Living with a spinal cord injury

A spinal cord injury can be life changing. A person may lose movement or feeling in parts of their body, and they may have trouble walking. Some people will need assistance with essential bodily functions, such as breathing and going to the toilet.

People with a spinal cord injury may require long-term rehabilitation, which may involve:

  • physical therapy to prevent muscle wastage, improve movement, and retrain other muscles
  • occupational therapy to learn new methods for carrying out everyday tasks
  • frequent medical checkups to monitor health and progress
  • pain management
  • seeing a therapist or counselor to help with emotional or mental health issues

Experiencing a spinal cord injury can cause emotional trauma, so it is important for a person to reach out to family, friends, and professionals for emotional support.

Ongoing research is also aiding the development and advancement of treatments in spinal cord repair.

Neurogenic shock can occur after a spinal cord injury, and it can be fatal.

Injury or trauma to the spinal cord can cause nerve damage, which affects how the body is able to regulate blood pressure and heart rate. This can impair blood flow, resulting in a lack of oxygen and nutrients reaching vital organs.

People will need to seek immediate medical attention if they suspect a spinal cord injury and have any symptoms of neurogenic shock. These include:

The outlook for people with neurogenic shock may depend on the severity of the spinal cord injury. Doctors can treat neurogenic shock with vasopressors, IV fluids, and surgery.