Hypotension in acute spinal injury is due to:
• High spinal cord injuries can also result in systemic hypotension because of loss of sympathetic tone.
• The patient will usually have hypotension and relative bradycardia and will show evidence of good peripheral perfusion on physical examination.
• The term neurogenic shock is used but is somewhat of a misnomer because these patients are typically hyperdynamic, with high cardiac output secondary to loss of sympathetic vascular tone.
Treatment
• Hypotension associated with high spinal injury can be treated by alpha-agonist phenylephrine.
Loss of sympathetic tone
Loss of parasympathetic tone
Orthostatic hypotension
Vasovagal attack