Effect of Alpha-1-Adrenergic Agonist, Midodrine for the Management of Long-Standing Neurogenic Shock in Patient with Cervical Spinal Cord Injury: A Case Report.
10.13004/kjnt.2015.11.2.147
- Author:
Taikwan KIM
1
;
Cheol Su JWA
Author Information
1. Department of Neurosurgery, National Medical Center, Seoul, Korea. chsjwa@hanmail.net
- Publication Type:Case Report
- Keywords:
Adrenergic alpha-agonists;
Hypotension;
Midodrine;
Spinal cord injuries
- MeSH:
Adrenergic alpha-Agonists;
Aged;
Blood Pressure;
Dopamine;
Humans;
Hypotension;
Male;
Midodrine*;
Reflex;
Shock*;
Spinal Cord Injuries*;
Spinal Cord*
- From:Korean Journal of Neurotrauma
2015;11(2):147-150
- CountryRepublic of Korea
- Language:English
-
Abstract:
We report a rare case of a 71-year-old male patient who had suffered from long-lasting neurogenic shock for 13 weeks after cervical spinal cord injury (SCI) caused by a bicycle accident. The neurogenic shock was resolved dramatically 2 weeks after the administration of alpha-1-adrenergic agonist, midodrine hydrochloride. In usual cases, neurogenic shock tends to improve between 2 and 6 weeks after SCI; however, in a few cases, the shock lasts for several months. In our case, spinal shock lasted for 13 weeks and exhibited very sensitive decline of blood pressure for even a slight decrease of dopamine despite recovered bulbospongiosus reflex. Three days after midodrine hydrochloride was added, hypotension improved dramatically. We discuss our rare case with pertinent literatures.
