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Question Date: 18/09/2023

Question: A patient with a chronic spinal cord injury develops extreme elevations of blood pressure, bradycardia, diaphoresis, and flushing whenever he develops severe constipation. What is the lowest level of spinal cord injury associated with this complication of spinal cord injury?

Options:

Correct Answer: T5

Explaination: Autonomic dysreflexia may occur with spinal cord injuries at levels of T6 or above. Various noxious stimuli such as bowel or bladder distension and bladder calculi can trigger a sympathetic response. The spinal cord injury prevents compensatory parasympathetic modulation (vasodilatation) of the sympathetic response. Treatment includes removal of the precipitating noxious stimulus, if possible, sitting the patient upright, and use of short-acting antihypertensive agents

Reference: Page 189 Abrams GM, Ganguly K. Management of chronic spinal cord dysfunction. Continuum (Minneap Minn). 2015 Feb21(1 Spinal Cord Disorders)188-200. doi 10.121201.CON.0000461092.86865.a4. PMID 25651225 PMCID PMC4325904