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Neurogenic Shock 

Neurogenic Shock
Chapter:
Neurogenic Shock
Author(s):

Arnoley S. Abcejo

, and Jeffrey J. Pasternak

DOI:
10.1093/med/9780190226459.003.0072
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date: 23 February 2020

Neurogenic shock is a pathophysiologic state of systemic hypoperfusion characterized by a significant decrease in systemic vascular resistance secondary to loss of sympathetic tone. Neurogenic shock is most commonly seen in the setting of acute spinal cord injury (SCI) but can also occur following significant brain injury. Interruption of sympathetic fibers causes loss of basal vascular sympathetic tone, commonly allowing unopposed parasympathetic tone. As a result, severe hypotension and bradycardia can further exacerbate neurologic injury and organ perfusion. Understanding the physiologic and anatomic changes of neurogenic shock can help direct appropriate resuscitation efforts. Physiologic goals should focus on reversing hypotension, preventing hypoxia, and optimizing perfusion of the injured central nervous system and other critical organs.

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