Management of cardio-vascular abnormalities caused by autonomic dysfunction in spinal cord injury

C. J. Mathias, H. L. Frankel and J. D. Cole

in Spinal Cord Dysfunction: Volume II: Intervention and Treatment

Published in print December 1991 | ISBN: 9780192617873
Published online March 2012 | e-ISBN: 9780191724312 | DOI:
Management of cardio-vascular abnormalities caused by autonomic dysfunction in spinal cord injury

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The activity of the autonomie nervous system is dependent on a cranial parasympathetic outflow and on spinal pathways, which traverse the cervical, thoracic, and lumbar sections of the spinal cord, with the sympathetic outflow emerging from the thoracic and upper lumbar segments, and the parasympathetic outflow from the sacral segments. In patients with spinal cord lesions the major proportion of the autonomie outflow may therefore be disrupted, resulting in inactivity, or dissociation of actions from cerebral regulation. A greater degree of disordered cardio-vascular control often occurs in patients with cervical and high thoracic spinal cord lesions. Activity of the autonomie nervous system, however, is also dependent on the afferent nervous system, and the level and extent of lesion thus influences responses. This chapter concentrates on the management of cardiovascular abnormalities which result from autonomie dysfunction in patients with high spinal cord injury. The initial description involves patients with acute lesions, as their cardio-vascular problems are often different from those in the chronic stages.

Keywords: autonomie nervous system; cranial parasympathetic outflow; spinal pathways; sacral segments; spinal cord lesions; cerebral regulation; cardio-vascular control; afferent nervous system; acute lesions

Chapter.  5170 words.  Illustrated.

Subjects: Neuroscience

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