Neurogenic Shock

Neurogenic Shock


Neurogenic Shock-Introduction

  • Neurogenic shock is a type of shock caused by the sudden loss of the autonomic nervous system signals to the smooth muscle in vessel walls.
  • This results in loss of background sympathetic stimulation, which is responsible for maintenence of tone of blood vessels.
  • As a result of loss of vascular tone, the vessels suddenly relax resulting in a sudden decrease in peripheral vascular resistance and decreased blood pressure.

Causes of Neurogenic Shock

Failure of the autonomic nervous system can arise from

  • Regional anesthesia
  • Injuries to the spinal cord (cervical spine and upper thoracic spine)
  • Administration of autonomic blocking agents.

Symptoms and Signs of Neurogenic Shock

  • Hypotension
  • Bradycardia
  • Warm and Dry extremitis
  • Peripheral vasodilation
  • Poikilothermia
  • Decreased cardiac output 

Treatment of Neurogenic Shock 

  • Fluids
  • Dopamine
  • Vasopressin (antidiuretic hormone)
  • Vasopressors like ephedrine, norepinephrine
  • Phenylephrine is used as first line or in patients who do not respond adequately to dopamine.
  • Atropine  if bradycardia is severe.
Exam Question
 
  • Peripheral resistance is decreased in Neurogenic shock
  • Neurogenic shock is characterized by Decreased peripheral vascular resistance
  • Feature of neurogenic shock is Bradycardia and hypotension
Don’t Forget to Solve all the previous Year Question asked on Neurogenic Shock

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