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Neurogenic Shock

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41. Neurogenic Bladder (Overview)

Lesions Neurogenic bladder from spinal cord lesions may take various forms, depending on the mechanism and site of injury. Spinal cord trauma When an individual sustains a spinal cord injury (eg, from a diving accident or motor vehicle injury), the initial neurologic response is spinal shock. During this spinal shock phase, the affected individual experiences flaccid paralysis below the level of injury, and the somatic reflex activity is either depressed or absent. The anal and bulbocavernosus reflex (...) Neurogenic Bladder (Overview) Neurogenic Bladder: Overview, Neuroanatomy, Physiology and Pathophysiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNDUzNTM5LW92ZXJ2aWV3 processing > Neurogenic Bladder Updated

2014 eMedicine.com

42. Neurogenic Bladder (Diagnosis)

Lesions Neurogenic bladder from spinal cord lesions may take various forms, depending on the mechanism and site of injury. Spinal cord trauma When an individual sustains a spinal cord injury (eg, from a diving accident or motor vehicle injury), the initial neurologic response is spinal shock. During this spinal shock phase, the affected individual experiences flaccid paralysis below the level of injury, and the somatic reflex activity is either depressed or absent. The anal and bulbocavernosus reflex (...) Neurogenic Bladder (Diagnosis) Neurogenic Bladder: Overview, Neuroanatomy, Physiology and Pathophysiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNDUzNTM5LW92ZXJ2aWV3 processing > Neurogenic Bladder Updated

2014 eMedicine.com

43. A patient with refractory shock induced by several factors, including obstruction because of a posterior mediastinal hematoma. (Abstract)

fractures, right hemopneumothorax with pulmonary contusion, and minor liver injury. After infusing 5000 mL of lactated Ringer's solution and 10 units of blood, his circulation remained unstable. On a repeat CT examination, the left atrium was found to be compressed by a posterior mediastinal hematoma induced by the fracture of the thoracic spine, and a diagnosis of shock induced by multiple factors, including hemorrhagic, neurogenic, and obstructive mechanisms, was made. After obtaining stable (...) A patient with refractory shock induced by several factors, including obstruction because of a posterior mediastinal hematoma. A 44-year-old man who drove a motorcycle experienced a collision with the side of another motorcycle. Because he had sustained a high-energy injury to the spinal cord, he was transferred to our hospital. His circulation was unstable, and received tracheal intubation in addition to thoracostomy for the hemothorax. Whole-body computed tomography (CT) revealed multiple

2015 American Journal of Emergency Medicine

44. Neurogenic stunned myocardium as a manifestation of encephalitis involving cerebellar tonsils. (Abstract)

Neurogenic stunned myocardium as a manifestation of encephalitis involving cerebellar tonsils. Neurogenic stunned myocardium is defined as a myocardial injury or dysfunction after neurological insults. It is most commonly reported in patients with subarachnoid hemorrhage, and the presenting symptoms may mimic an acute myocardial infarction or myocarditis. In severe cases, cardiogenic shock and acute pulmonary edema may occur and lead to a devastating event. Therefore, it requires prompt (...) recognition and proper intervention. We herein report the case of a 25-year-old woman who presented to our hospital with the symptoms of acute pulmonary edema, shock, and consciousness disturbance. The diagnosis of encephalitis of cerebellar tonsils complicated with acute hydrocephalus and neurogenic stunned myocardium was made. Detailed neurologic examinations, neuroimaging studies, and characteristic echocardiographic changes expedite the correct diagnosis and treatment.

2012 American Journal of Emergency Medicine

45. [Sacral neuromodulation for neurogenic bladder dysfunction]. Full Text available with Trip Pro

[Sacral neuromodulation for neurogenic bladder dysfunction]. Sacral neuromodulation (SNM) represents a promising option for managing treatment-refractory neurogenic bladder dysfunction. It remains to be seen, however, which types of neurogenic bladder dysfunction and which underlying neurological disorders best respond to SNM. Constant improvements in SNM have been achieved and it is now a minimally invasive approach performed under local anesthesia which should be considered before undertaking (...) that SNM produces a modulation of medullary reflexes and brain centers by peripheral afferents. The implanted neuromodulation system does not lead to limitation of the patient's activities. However, it should be noted that high-frequency diathermy and unipolar electrocauterization are contraindicated in patients with neuromodulators, that during extracorporeal shock wave lithotripsy the focal point should not be in the direct vicinity of the neuromodulator or the electrode, that ultrasound

2012 Der Urologe. Ausg. A

46. Dopamine-induced neurogenic vaso-dilatation in the intact hindleg of the dog. Full Text available with Trip Pro

to atropine or propranolol and (iv) it was blocked by small doses of haloperidol. When hypovolemic shock was produced, the incidence of the neurogenic decrease of vascular resistance was smaller. 5 Dopamine also increased renal blood flow. This increase was not reduced by the occurrence of the neurogenic vasodilation in the inervated femoral artery. 6 These results are consistent with the idea that the dopamine-induced neurogenic vasodilation, originally described in the isolated perfused hindleg (...) Dopamine-induced neurogenic vaso-dilatation in the intact hindleg of the dog. 1 The dopamine-induced neurogenic vasodilation, previously described in the isolated perfused hindleg of the dog, has been studied in anaesthetized dogs with intact circulation in the hindleg. Dopamine was administered intravenously and/or intra-aortically, either as a bolus injection of 4 or 1l mug/kg, or as a continuous infusion of 4, 8, 16 or 32 mug kg-1 min-1. 2 Dopamine, given as a bolus injection or by infusion

1977 British journal of pharmacology

47. Tissue and plasma catecholamines and dopamine beta-hydroxylase activity of various animal species after neurogenic sympathetic stimulation. Full Text available with Trip Pro

Tissue and plasma catecholamines and dopamine beta-hydroxylase activity of various animal species after neurogenic sympathetic stimulation. 1. The effects of reserpine and exposure to a stressing atmosphere containing 20% CO2 for 5 hr on catecholamine (CA) levels and dopamine beta-hydroxylase (DBH) activity of adrenal, spleen and plasma of cat, rabbit, rat and guinea-pig were studied. 2. Twenty-four hr after an I.P. injection of reserpine, the CA contents of the adrenals and spleens were (...) activity to CA in the spleen and adrenal were much higher in the guinea-pig than in the rat. The fraction of the total DBH activity that can be solubilized by osmotic shock of purified adrenomedullary chromaffin granules was 28% in the rat and 71% in the guinea-pig. If one makes the assumption that 'soluble' and 'releasable' DBH may be equated, the amount of 'releasable' DBH into the circulation is much greater in the guinea-pig than in the rat. 7. The results suggest that the guinea-pig is a better

1978 The Journal of physiology

48. Shock, Distributive (Overview)

in intensive care units (ICUs). (See , , , and .) Other causes of distributive shock include (SIRS) due to noninfectious inflammatory conditions such as burns and pancreatitis; ( ); anaphylaxis; reactions to drugs or toxins, including insect bites, transfusion reaction, and heavy metal poisoning; addisonian crisis; hepatic insufficiency; and neurogenic shock due to brain or spinal cord injury. (See and .) Types of shock Shock is a clinical syndrome characterized by inadequate tissue perfusion that results (...) SVR is due primarily to massive histamine release from mast cells after activation by antigen-bound immunoglobulin E (IgE), as well as increased synthesis and release of prostaglandins. Neurogenic shock is due to loss of sympathetic vascular tone from severe injury to the nervous system. Previous Next: Etiology The most common etiology of distributive shock is sepsis. Other causes include the following: SIRS due to noninfectious conditions such as pancreatitis, burns, or trauma TSS Anaphylaxis

2014 eMedicine.com

49. Shock, Distributive (Diagnosis)

in intensive care units (ICUs). (See , , , and .) Other causes of distributive shock include (SIRS) due to noninfectious inflammatory conditions such as burns and pancreatitis; ( ); anaphylaxis; reactions to drugs or toxins, including insect bites, transfusion reaction, and heavy metal poisoning; addisonian crisis; hepatic insufficiency; and neurogenic shock due to brain or spinal cord injury. (See and .) Types of shock Shock is a clinical syndrome characterized by inadequate tissue perfusion that results (...) SVR is due primarily to massive histamine release from mast cells after activation by antigen-bound immunoglobulin E (IgE), as well as increased synthesis and release of prostaglandins. Neurogenic shock is due to loss of sympathetic vascular tone from severe injury to the nervous system. Previous Next: Etiology The most common etiology of distributive shock is sepsis. Other causes include the following: SIRS due to noninfectious conditions such as pancreatitis, burns, or trauma TSS Anaphylaxis

2014 eMedicine.com

50. Shock, Hemorrhagic (Overview)

difficult because not all tissues and organs will experience the same amount of oxygen imbalance for a given clinical disturbance. Clinicians struggle daily to adequately define and monitor oxygen utilization on the cellular level and to correlate this physiology to useful clinical parameters and diagnostic tests. The 4 classes of shock, as proposed by Alfred Blalock, are as follows [ ] : Hypovolemic Vasogenic (septic) Cardiogenic Neurogenic Hypovolemic shock, the most common type, results from a loss (...) Shock, Hemorrhagic (Overview) Hemorrhagic Shock: Background, Pathophysiology, Epidemiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNDMyNjUwLW92ZXJ2aWV3 processing > Hemorrhagic Shock Updated: Sep 12, 2018

2014 eMedicine Surgery

51. Shock, Hemorrhagic (Diagnosis)

difficult because not all tissues and organs will experience the same amount of oxygen imbalance for a given clinical disturbance. Clinicians struggle daily to adequately define and monitor oxygen utilization on the cellular level and to correlate this physiology to useful clinical parameters and diagnostic tests. The 4 classes of shock, as proposed by Alfred Blalock, are as follows [ ] : Hypovolemic Vasogenic (septic) Cardiogenic Neurogenic Hypovolemic shock, the most common type, results from a loss (...) Shock, Hemorrhagic (Diagnosis) Hemorrhagic Shock: Background, Pathophysiology, Epidemiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNDMyNjUwLW92ZXJ2aWV3 processing > Hemorrhagic Shock Updated: Sep 12, 2018

2014 eMedicine Surgery

52. Reversible cardiogenic shock due to catecholamine-induced cardiomyopathy: a variant of takotsubo? (Abstract)

Reversible cardiogenic shock due to catecholamine-induced cardiomyopathy: a variant of takotsubo? Catecholamine-induced cardiomyopathy, including takotsubo, neurogenic stunned myocardium, and pheochromocytoma-related cardiomyopathy, is a reversible and generally benign condition. We are reporting a case series of young women who had cardiogenic shock and pulmonary edema due to severe left ventricular systolic dysfunction, which completely recovered in the course of 2 to 3 weeks. Both patients

2013 American Journal of Emergency Medicine

53. Heparin Anticoagulation to Improve Outcomes in Septic Shock: The HALO Pilot

) Need for invasive mechanical ventilation or a P/F ratio < 250 Platelets < 100 x109/L, or a drop of 50 x109/L in the 3 days prior to enrollment Arterial pH < 7.30 or base deficit > 5 mmol/L in association with a lactate >/= to 3.0 mmol/L Exclusion Criteria: Consent declined Clinically apparent other forms of shock including cardiogenic, obstructive (massive pulmonary embolism, cardiac tamponnade, tension pneumothorax), hemorrhagic, neurogenic, or anaphylactic Received vasopressor therapy for greater (...) Heparin Anticoagulation to Improve Outcomes in Septic Shock: The HALO Pilot Heparin Anticoagulation to Improve Outcomes in Septic Shock: The HALO Pilot - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more

2012 Clinical Trials

54. Temperature variability analysis using wavelets and multiscale entropy in patients with systemic inflammatory response syndrome, sepsis, and septic shock Full Text available with Trip Pro

2), and seven had septic shock (group 3). All temperature curves were studied during the first 24 hours of an inflammatory state. A wavelet transformation was applied, decomposing the signal in different frequency components (scales) that have been found to reflect neurogenic and metabolic inputs on temperature oscillations. Wavelet energy and entropy per different scales associated with complexity in specific frequency bands and multiscale entropy of the whole signal were calculated. Moreover (...) Temperature variability analysis using wavelets and multiscale entropy in patients with systemic inflammatory response syndrome, sepsis, and septic shock Even though temperature is a continuous quantitative variable, its measurement has been considered a snapshot of a process, indicating whether a patient is febrile or afebrile. Recently, other diagnostic techniques have been proposed for the association between different properties of the temperature curve with severity of illness

2012 Critical Care

55. Critical care - Shock

beds; this bypass plus uncoupled cellular O 2 transport cause cellular hypoperfusion (shown by decreased O 2 consumption). In other situations, blood pools in venous capacitance beds and cardiac output falls. Distributive shock may be caused by (anaphylactic shock); bacterial infection with endotoxin release ( ); severe injury to the spinal cord, usually above T4 (neurogenic shock); and ingestion of certain drugs or poisons, such as nitrates, opioids, and adrenergic blockers. Anaphylactic shock (...) Critical care - Shock Shock - Critical Care Medicine - MSD Manual Professional Edition Brought to you by The trusted provider of medical information since 1899 SEARCH SEARCH MEDICAL TOPICS Common Health Topics Resources QUIZZES & CASES Quizzes Cases The trusted provider of medical information since 1899 SEARCH SEARCH MEDICAL TOPICS Common Health Topics Resources QUIZZES & CASES Quizzes Cases / / / / IN THIS TOPIC OTHER TOPICS IN THIS CHAPTER Test your knowledge Cardiopulmonary Resuscitation

2013 Merck Manual (19th Edition)

56. Spinal shock

: Ditunno, JF; Little, JW; Tessler, A; Burns, AS (2004). "Spinal shock revisited: a four-phase model". Spinal cord : the official journal of the International Medical Society of Paraplegia 42 (7): 383–95. URL: Note: Differentiate spinal shock from neurogenic shock, which refers to the hemodynamic triad of hypotension, bradycardia, and peripheral vasodilation resulting from severe autonomic dysfunction. Neurogenic shock is due to the interruption of sympathetic nervous system control in acute spinal cord (...) Spinal shock Emergency Medicine Blog: Spinal shock Sunday, June 16, 2013 Spinal shock Spinal shock is not really "shock" in the sense of circulatory collapse but rather a transient or temporary (physiologic rather than anatomical) complete loss of all neurologic function, including reflexes and rectal tone, below a specific level that is associated with autonomic dysfunction. This phenomenon was first described in 1750 by Whytt. Spinal shock begins within a few minutes following an acute spinal

2013 Emergency Medicine Blog

57. Acute cervical spine trauma

tenderness male sex age 18 to 25 years intoxication numbness, tingling, or weakness of extremities bowel or bladder dysfunction motor weakness sensory loss reduced or painful cervical range of motion (ROM) loss of anorectal tone and perianal sensation spasticity hyper-reflexia Babinski's sign Hoffman's sign neurogenic shock spinal shock respiratory change cranial nerve deficit male sex female sex (whiplash injury) lack of preparation or awareness of collision head rotated at time of collision previous

2018 BMJ Best Practice

58. Spinal cord compression

of symptoms back pain numbness or paraesthesias weakness or paralysis bladder or bowel dysfunction hyper-reflexia sensory loss muscle weakness or wasting loss of tone below level of suspected injury (spinal shock) hypotension and bradycardia (neurogenic shock) complete cord transection syndrome cauda equina syndrome central cord syndrome history of malignancy immunosuppression intravenous drug use loss of rectal sphincter reflex loss of appendicular reflexes local deformity of spine on palpation Brown

2018 BMJ Best Practice

59. Assessment of respiratory alkalosis

in adults Asthma in children Hypoxaemia Cirrhosis Cardiopulmonary bypass Pneumothorax Meningitis Encephalitis Brain tumour Traumatic brain injury Mechanical ventilation High altitude-related illness Generalised anxiety disorder Idiopathic pulmonary arterial hypertension Interstitial pulmonary fibrosis Central sleep apnoea Hypovolaemic shock Severe anaemia Lung contusion Central neurogenic hyperventilation Hyperventilation syndrome Hyperthermic hyperpnoea Cyanotic heart disease Haemoglobinopathy (...) /6410136?tool=bestpractice.com If hypocapnia occurs with acidaemia, a primary respiratory alkalosis is present, if the degree of hypocapnia is greater than would be expected in response to the coexisting metabolic acidosis. Differentials Pulmonary embolism Sepsis and systemic inflammatory-response syndrome (SIRS) Acute respiratory distress syndrome (ARDS) Pneumonia Cardiogenic shock Pulmonary oedema Ischaemic stroke Haemorrhagic stroke Salicylate overdose Pseudorespiratory alkalosis Pregnancy Asthma

2018 BMJ Best Practice

60. Guidelines on Diagnosis and Management of Syncope

(neurogenic OH): - pure autonomic failure, multiple system atrophy, Parkinson’s disease, dementia with Lewy bodies Secondary autonomic failure (neurogenic OH): - diabetes, amyloidosis, spinal cord injuries, auto-immune autonomic neuropathy, paraneoplastic autonomic neuropathy, kidney failure Cardiac syncope Arrhythmia as primary cause: Bradycardia: - sinus node dysfunction (including bradycardia/tachycardia syndrome) - atrioventricular conduction system disease Tachycardia: - supraventricular (...) Note that hypotension may be exacerbated by venous pooling during exercise (exercise-induced), after meals (postprandial hypotension), and after prolonged bed rest (deconditioning). Drug-induced OH (most common cause of OH): - e.g. vasodilators, diuretics, phenothiazine, antidepressants Volume depletion: - haemorrhage, diarrhoea, vomiting, etc. Primary autonomic failure (neurogenic OH): - pure autonomic failure, multiple system atrophy, Parkinson’s disease, dementia with Lewy bodies Secondary

2018 European Society of Cardiology

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