Liječnički vjesnik, Vol. 139 No. 1-2, 2017.
Review article
AUTONOMIC DYSREFLEXIA
Dean Markić
Josip Šimičić
Nada Strčić
Marin Trošelj
Igor Grubišić
David Bonifačić
Abstract
Autonomic dysrefl exia (AD) is a syndrome that occurs in patients with high spinal cord lesion. It is caused by
activation of sympathetic nervous system by a noxious stimulus below the level of injury, usually consisting of distention
and/or irritation of the bladder or constipation. Sympathetic system activation leads to blood pressure elevation because
compensatory mechanisms cannot properly regulate blood pressure due to the spinal cord lesions. The most important
manifestation of AD is arterial hypertension because of the possible cerebrovascular and cardiovascular complications,
including death. Initial treatment consists of recognition of the symptoms and resolution of the cause. In patients with high
blood pressure antihypertensive therapy is initiated (with nifedipine, captopril and nitroglycerin). Prevention is also a very
important task, with the goal of infl uencing all possible triggers of this condition, specially micturition and colon disorders.
One of the most important tasks is educating patients, their caregivers and health professionals about AD
Keywords
Autonomic dysrefl exia – complications, etiology, physiopathology, therapy; Spinal cord injuries – complications, physiopathology; Hypertension – drug therapy, etiology; Antihypertensive agents – therapeutic use; Urinary bladder – physiopathology; Urinary catheterization; Rectum – physiopathology; Algorithms
Hrčak ID:
178449
URI
Publication date:
23.3.2017.
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