Neurogenic shock

Mechanism and manifestations

It threatens organ and cord perfusion. After trauma, bleeding and other shock causes must also be investigated; a low heart rate does not exclude a severe emergency.

Diagnosis and management

Care belongs in hospital, with monitoring and hemodynamic support appropriate to the cause. It must not be confused with spinal shock or treated with manipulation, exercise or office modalities.

Points to consider

A neurological syndrome describes a pattern; its cause, level and evolution still need investigation. Functional consequences may change over time. New or rapidly worsening deficits need hospital assessment even when a neurological diagnosis is already known.

Role of TAGMED care

With acute symptoms, urgent hospital assessment takes priority. This condition first requires medical diagnosis and, depending on the situation, specialist management. TAGMED services do not replace treatment of infection or tumor, stabilization of an unstable injury, or neurological or vascular treatment. Any conservative support should be considered only after diagnosis, restrictions and the treating team’s recommendations have been clarified.

Related concepts and distinctions

These concepts belong to the same field, but are not synonyms.

• Spinal shock — Period of reduced or absent reflexes and tone below an acute spinal cord injury, evolving over a variable duration.
• Autonomic dysreflexia — Episode of autonomic overactivity causing potentially dangerous blood-pressure elevation in some people with spinal cord injury, often at or above T6.
• Anterior cord syndrome — Cord injury pattern mainly affecting anterior-region functions, with motor and pain-temperature impairment and relative preservation of dorsal-column functions.

Medical references

1. American Association of Neurological Surgeons. Spinal Cord Injury.
2. U.S. National Library of Medicine, MedlinePlus. Spinal Cord Injuries.

References document the topic; their inclusion does not imply endorsement of TAGMED services by those organizations.