Diferencia entre revisiones de «Spinal shock»
Sin resumen de edición |
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| Línea 5: | Línea 5: | ||
**Can make an incomplete lesion appear as complete | **Can make an incomplete lesion appear as complete | ||
***Cord lesions cannot be deemed complete until spinal shock has resolved | ***Cord lesions cannot be deemed complete until spinal shock has resolved | ||
*Can think of it as a "concussion" of the spinal cord | |||
==Clinical Features== | |||
*Bulbocavernosus reflex is among the first to return as spinal shock resolves | *Bulbocavernosus reflex is among the first to return as spinal shock resolves | ||
**Performed by squeezing glans of penis or clitoris and monitoring for anus contraction | **Performed by squeezing glans of penis or clitoris and monitoring for anus contraction | ||
| Línea 10: | Línea 13: | ||
*Usually lasts day to weeks | *Usually lasts day to weeks | ||
**Resolves when soft tissue swelling improves | **Resolves when soft tissue swelling improves | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Shock DDX}} | {{Shock DDX}} | ||
==Evaluation== | |||
==Management== | |||
==Disposition== | |||
*Admission | |||
==See Also== | ==See Also== | ||
| Línea 19: | Línea 30: | ||
*[[Spinal Cord Compression (Non-Traumatic)]] | *[[Spinal Cord Compression (Non-Traumatic)]] | ||
*[[Neurogenic Shock]] | *[[Neurogenic Shock]] | ||
==External Links== | |||
==References== | ==References== | ||
Revisión actual - 20:39 29 abr 2020
Background
- Do not confuse with Neurogenic Shock
- Transient stunning of the cord with global loss of function (unlike neurogenic shock) with temporary loss of spinal cord function below complete or incomplete spinal cord injury
- Flaccid paralysis, anesthesia, absent bowel/bladder control and reflex activity, priapism
- Can make an incomplete lesion appear as complete
- Cord lesions cannot be deemed complete until spinal shock has resolved
- Can think of it as a "concussion" of the spinal cord
Clinical Features
- Bulbocavernosus reflex is among the first to return as spinal shock resolves
- Performed by squeezing glans of penis or clitoris and monitoring for anus contraction
- Mediated by S2-S4
- Usually lasts day to weeks
- Resolves when soft tissue swelling improves
Differential Diagnosis
Shock
- Cardiogenic
- Acute valvular Regurgitation/VSD
- CHF
- Dysrhythmia
- ACS
- Myocardial Contusion
- Myocarditis
- Drug toxicity (e.g. beta blocker, CCB, or bupropion OD)
- Obstructive
- Distributive
- Hypovolemic
- Severe dehydration
- Hemorrhagic shock (traumatic and non-traumatic)
Evaluation
Management
Disposition
- Admission