Increased vascular resistance in paralyzed legs after spinal cord injury is reversible by training

2002 ◽  
Vol 93 (6) ◽  
pp. 1966-1972 ◽  
Author(s):  
Maria T. E. Hopman ◽  
Jan T. Groothuis ◽  
Marcel Flendrie ◽  
Karin H. L. Gerrits ◽  
Sibrand Houtman
Keyword(s):  
Blood Pressure ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Blood Flow ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Vascular Resistance ◽  
Arterial Blood Flow ◽  
Arterial Blood ◽  
Cord Injury

The purpose of the present study was to determine the effect of a spinal cord injury (SCI) on resting vascular resistance in paralyzed legs in humans. To accomplish this goal, we measured blood pressure and resting flow above and below the lesion (by using venous occlusion plethysmography) in 11 patients with SCI and in 10 healthy controls (C). Relative vascular resistance was calculated as mean arterial pressure in millimeters of mercury divided by the arterial blood flow in milliliters per minute per 100 milliliters of tissue. Arterial blood flow in the sympathetically deprived and paralyzed legs of SCI was significantly lower than leg blood flow in C. Because mean arterial pressure showed no differences between both groups, leg vascular resistance in SCI was significantly higher than in C. Within the SCI group, arterial blood flow was significantly higher and vascular resistance significantly lower in the arms than in the legs. To distinguish between the effect of loss of central neural control vs. deconditioning, a group of nine SCI patients was trained for 6 wk and showed a 30% increase in leg blood flow with unchanged blood pressure levels, indicating a marked reduction in vascular resistance. In conclusion, vascular resistance is increased in the paralyzed legs of individuals with SCI and is reversible by training.

scholarly journals Priapism after spinal cord injury – a case report and review of the literature

2021 ◽  
Vol 13 ◽  
pp. 175628722110391
Author(s):  
Jeff John ◽  
Noma Mngqi ◽  
Ken Kesner
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Blood Flow ◽  
Stab Wound ◽  
Arterial Blood Flow ◽  
Review Of The Literature ◽  
Management Options ◽  
Sudden Loss ◽  
Arterial Blood ◽  
Cord Injury

Involuntary unwanted erections are extremely rare after spinal cord injury (SCI). A sudden loss of sympathetic tone to the pelvic vasculature following SCI causes an increase in the parasympathetic tone and uncontrolled arterial blood flow into the penile sinusoidal spaces. When occurring immediately after an acute SCI, it is generally self-limiting and settles within a few hours. In contrast, recurrent, unwanted erections in patients with chronic SCI are more unpredictable in frequency and duration and may require treatment. We present a case of recurrent involuntary unwanted erections in a patient with chronic SCI after a stab wound to his neck and review the pathophysiology and available management options.

Posterior Reversible Encephalopathic Syndrome in the Setting of Induced Elevated Mean Arterial Pressure in Patients With Spinal Cord Injury

Neurosurgery ◽  
2017 ◽  
Vol 83 (1) ◽  
pp. 16-21 ◽  
Author(s):  
Alexander C Whiting ◽  
Manuel P Fanarjian ◽  
Randall J Hlubek ◽  
Jakub Godzik ◽  
U Kumar Kakarla ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Case Series ◽  
Neurological Status ◽  
Cord Injury ◽  
Treatment Paradigm ◽  
Blood Pressure Goals

Abstract BACKGROUND AND IMPORTANCE Acute spinal cord injury (SCI) is managed by avoiding hypotension and elevating mean arterial pressure (MAP) to attain optimal perfusion of the spinal cord. Few studies have been published regarding complications related to this treatment paradigm. CLINICAL PRESENTATION Three patients with SCI developed posterior reversible encephalopathic syndrome (PRES) during treatment with intravenous fluids and vasopressors administered to maintain elevated MAPs. All of them experienced temporary elevations well above the standard blood pressure goals for acute SCI and deterioration of neurological status. CONCLUSION PRES is a potential complication of elevated MAPs in patients with SCI, particularly if the blood pressure rises above the goals of standard treatment paradigms. The neurosurgical staff should be suspicious of possible PRES early in the course of acute SCI in patients with unexplained neurological decline. This case series is the first report of PRES in patients with acute SCI.

scholarly journals Passive Leg Movements and Passive Cycling Do Not Alter Arterial Leg Blood Flow in Subjects With Spinal Cord Injury

2006 ◽  
Vol 86 (5) ◽  
pp. 636-645 ◽  
Author(s):  
Walter Ter Woerds ◽  
Patricia CE De Groot ◽  
Dirk HJM van Kuppevelt ◽  
Maria TE Hopman
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Blood Flow ◽  
Vascular Resistance ◽  
Secondary Complications ◽  
Leg Blood Flow ◽  
Cord Injury ◽  
Leg Movements

Background and Purpose. Subjects with a spinal cord injury (SCI) are at increased risk for cardiovascular disease–related secondary complications, such as pressure ulcers and attenuated wound healing. It has been suggested that passive exercise enhances blood flow via mechanical pump effects or reflex activation. The purpose of this study was to assess the effects of passive leg movements and passive cycling on the arterial circulation in subjects with SCI. Subjects. Eight men with motor complete SCI and 8 male control subjects participated. Methods. Echo Doppler measurements were obtained to measure leg blood flow at rest, during and after 10 minutes of standardized passive leg movements, and during and after 20 minutes of passive leg cycling. Blood pressure was measured continuously, and total vascular resistance and leg vascular resistance were calculated. Results. In both groups, no changes in leg blood flow, vascular resistance, or blood pressure were observed during or after the 2 interventions. Discussion and Conclusion. The results of the study demonstrate that passive leg movements and passive cycling do not alter the arterial peripheral circulation in subjects with SCI or control subjects. Although the results do not support the use of passive movements or exercise for the prevention of cardiovascular disease–related secondary complications, physical therapists should not be dissuaded from using these techniques to address musculoskeletal concerns.

scholarly journals Cerebral Autoregulation during Postural Change in Patients with Cervical Spinal Cord Injury—A Carotid Duplex Ultrasonography Study

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1321
Author(s):  
Joo-Hyun Kee ◽  
Jun-Hyeong Han ◽  
Chang-Won Moon ◽  
Kang Hee Cho
Keyword(s):  
Blood Pressure ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Blood Flow ◽  
Cerebral Autoregulation ◽  
Duplex Ultrasonography ◽  
Postural Change ◽  
Carotid Duplex ◽  
Cord Injury ◽  
Carotid Duplex Ultrasonography

Patients with a spinal cord injury (SCI) frequently experience sudden falls in blood pressure during postural change. Few studies have investigated whether the measurement of blood flow velocity within vessels can reflect brain perfusion during postural change. By performing carotid duplex ultrasonography (CDU), we investigated changes in cerebral blood flow (CBF) during postural changes in patients with a cervical SCI, determined the correlation of CBF change with presyncopal symptoms, and investigated factors affecting cerebral autoregulation. We reviewed the medical records of 100 patients with a cervical SCI who underwent CDU. The differences between the systolic blood pressure, diastolic blood pressure, and CBF volume in the supine posture and after 5 min at 50° tilt were evaluated. Presyncopal symptoms occurred when the blood flow volume of the internal carotid artery decreased by ≥21% after tilt. In the group that had orthostatic hypotension and severe CBF decrease during tilt, the body mass index and physical and functional scores were lower than in other groups, and the proportion of patients with a severe SCI was high. The higher the SCI severity and the lower the functional score, the higher the possibility of cerebral autoregulation failure. CBF should be assessed by conducting CDU in patients with a high-level SCI.

MEAN ARTERIAL PRESSURE MAINTENANCE FOLLOWING SPINAL CORD INJURY

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Jordan A. Weinberg ◽  
S. Harrison Farber ◽  
Louay D. Kalamchi ◽  
Scott T. Brigeman ◽  
Michael A. Bohl ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Cord Injury
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