Case Report of Autonomic Dysreflexia in a Pressure Sore Patient.
- Author:
Seung Min NAM
1
;
Eun Soo PARK
;
Sun A PARK
;
Young Bae KIM
Author Information
1. Departments of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University, Bucheon, Korea. peunsoo@schbc.ac.kr
- Publication Type:Case Report
- Keywords:
AD;
Pressure sore
- MeSH:
Autonomic Dysreflexia*;
Autonomic Nervous System;
Blood Pressure;
Bradycardia;
Chest Pain;
Headache;
Humans;
Hypertension;
Lower Extremity;
Middle Aged;
Patients' Rooms;
Pressure Ulcer*;
Quadriplegia;
Reflex;
Spinal Cord;
Spinal Cord Injuries;
Stroke;
Stupor;
Sweat;
Sweating;
Urinary Bladder;
Vital Signs;
Wounds and Injuries
- From:Journal of the Korean Society of Plastic and Reconstructive Surgeons
2007;34(4):530-533
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Plastic surgeons are responsible for the management of spinal cord injury patients with upper and lower extremity reconstruction, pressure sore, and wounds. Derailment of autonomic nervous systems caused by injury to the spinal cord may result in fatal autonomic dysreflexia. Autonomic dysreflexia is a syndrome of massive imbalance of reflex sympathetic discharge occurring in patients with spinal cord lesion above the splanchnic outflow(T6). It is characterized by a sudden onset and severe increase in blood pressure and is potentially life threatening. The other classic symptoms are headache, chest pain, sweating, and bradycardia. In order to lower the blood pressure, it is important to remove the noxious stimulus for autonomic dysreflexia. If such symptoms last for more than 15 minutes despite conservative interventions, antihypertension drugs are recommended. METHODS: In this case study, we report an autonomic dysreflexia case that developed in a 45 year-old tetraplegia patient with sacral pressure sore. When he got bladder irrigation, his blood pressure went up very high and his mentality became stuporous. He was sent to ICU for his blood pressure and mental care. ICU care made his vital sign stabilized and his mentality alert. RESULTS: After the patient underwent proper treatment like inotropic agent, he was transferred to the general ward and his pressure sore on sacral area was coveraged with gluteus maximus myocutaneous advancement flap. CONCLUSION: If treatment is not effective, the patients have to undergo sudden, severe hypertension, which can cause stroke or death. To provide safe and effective care, plastic surgeons should be able to recognize and treat autonomic dysreflexia.
