Intracerebral hemorrhage secondary to autonomic dysreflexia in a young person with incomplete C8 tetraplegia: A case report

• Published in: Archives of physical medicine and rehabilitation Vol. 86; no. 3; pp. 591 - 593
• Main Authors: Pan, Shin-Liang, Wang, Yen-Ho, Lin, Hui-Lin, Chang, Chein-Wei, Wu, Ti-Yi, Hsieh, Eou-Ting
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.03.2005; Elsevier
• Subjects: Adult; Autonomic dysreflexia; Autonomic Dysreflexia - complications; Autonomic Dysreflexia - physiopathology; Autonomic Dysreflexia - rehabilitation; Biological and medical sciences; Case report; Cerebral Hemorrhage - etiology; Delivery. Postpartum. Lactation; Gynecology. Andrology. Obstetrics; Humans; Intracerebral hemorrhage; Male; Medical sciences; Miscellaneous; Nervous system (semeiology, syndromes); Nervous system as a whole; Neurology; Quadriplegia; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Rehabilitation; Spinal cord injuries; Spinal Cord Injuries - complications; Autonomic dysreflexia; Case report; Spinal cord injuries; Rehabilitation; Intracerebral hemorrhage; Brain; Prognosis; Motor system disorder; Check; Cardiovascular disease; Male; Hemorrhage; Prevention; Vascular disease; Hernia; Regulation(control); Reeducation; Complication; Arterial pressure; Blood pressure; Neurological disorder; Triggering; Cerebrovascular disease; Human; Tetraplegia; Stroke; Secondary; Critically ill; Ablation; Fatal course; Cerebral disorder; Case study; Central nervous system disease; Recognition
• ISSN: 0003-9993; 1532-821X
• DOI: 10.1016/j.apmr.2004.03.021

Pan S-L, Wang Y-H, Lin H-L, Chang C-W, Wu T-Y, Hsieh E-T. Intracerebral hemorrhage secondary to autonomic dysreflexia in a young person with incomplete C8 tetraplegia: a case report. Intracerebral hemorrhage is an unusual complication of autonomic dysreflexia and can be fatal if massive bleeding occurs with brain herniation. We report the case of a man in his midthirties with incomplete tetraplegia who suffered right putaminal hemorrhage during an episode of autonomic dysreflexia. Prompt recognition and removal of the triggering factors of autonomic dysreflexia quickly brought his blood pressure under control and the patient had a favorable functional outcome after rehabilitation. A review of the literature suggests that the location of hemorrhage in autonomic dysreflexia-induced cases is similar to that in the general population. The most common triggering factors are bladder distension in men and labor induction in women. Hemorrhagic stroke can also occur in patients with incomplete spinal cord injury (SCI) who develop autonomic dysreflexia. The role of sympathetic skin response examination is also discussed. This life-threatening complication should be kept in mind in the case of people with SCI.