Neurogenic shock is a dangerous medical emergency that needs to be treated right away. It can happen after you’ve had a spinal cord injury, which can keep your body from regulating its own blood pressure, heart rate and temperature. Neurogenic shock is a critical condition because it keeps oxygen from reaching your organs.
Neurogenic shock is a condition in which you have trouble keeping your heart rate, blood pressure and temperature stable because of damage to your nervous system after a spinal cord injury. Like other types of shock, this is a serious condition that can be fatal because your blood flow is too low. Without normal blood flow, your cells can’t get the oxygen and nutrients they need to do their jobs.
You should get treatment for shock right away.
Neurogenic shock vs. spinal shock
With spinal shock, your muscles are limp and you don’t have your reflexes after a spinal cord injury.
People whose nervous system is hurt after a spinal cord injury can get neurogenic shock.
Studies estimate that 19% to 31% of people with a spinal cord injury get neurogenic shock. Each year, about 8,000 to 10,000 people in America injure their spinal cord — mostly through car crashes and falls.
When you have a spinal cord injury, it can prevent your nerves from telling your blood vessels to constrict. Without getting this command, your blood vessels can open up too much (vasodilation). This lowers your blood pressure and your blood flow, which means your organs can’t get enough oxygen.
Symptoms of neurogenic shock include:
Causes of neurogenic shock include:
To diagnose neurogenic shock, your healthcare provider will:
Your provider may order these scans:
Your provider will put a collar or neck brace on your neck to keep your injury from getting worse.
First, your provider will treat your low blood pressure with fluids you receive through an IV. Next, your provider will treat your slow heart rhythm. In addition to neurogenic shock treatment, providers will also give you treatment for injuries from your accident.
For neurogenic shock management, your provider may order several different medicines, including:
Any medications can have side effects, but your provider chooses medicines with benefits that outweigh the risks. Also, there is a chance that the IV fluids you get can lead to swelling.
Preventing a spinal cord injury greatly reduces your risk of neurogenic shock. To do this, you can try to avoid accidents that can cause a spinal cord injury in these ways:
It’s possible to have hypotension (low blood pressure) for five weeks after your injury. You may also get a deep vein thrombosis (DVT), stress ulcer or aspiration pneumonia (from inhaling something other than air).
Neurogenic shock symptoms can last four to five weeks.
Returning to work or school will depend on the extent of your spinal cord injury and other injuries from your accident. You may need to make major changes in your life to accommodate your limited mobility.
Without treatment, shock is most often fatal. With treatment, your outlook depends on:
Having a spinal cord injury makes you two to five times as likely to die early compared to those who don’t have that injury. The risk of death is highest in the first year after a spinal cord injury.
Because of your spinal cord injury, you’ll be more likely to have other problems like deep vein thrombosis. Also, one or more of your organs may be damaged because of the lack of blood flow during neurogenic shock. Every case is different, but anyone who’s had neurogenic shock should keep up with physical therapy and provider appointments to prevent future problems.
You should contact your provider if anything changes with your condition: vital signs, your pain level, etc.
You should get immediate help if you have:
A note from Cleveland Clinic
Neurogenic shock is a medical emergency that needs to be treated as soon as possible. Once you’re out of immediate danger, you can focus on the longer-term impact of your spinal cord injury. Your healthcare team can help you make a plan for how to manage your medical and mobility issues.
Last reviewed by a Cleveland Clinic medical professional on 11/30/2021.
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