Neurogenic shock is shock caused by the sudden loss of the autonomic nervous system signals to the smooth muscle in vessel walls. This can result from severe central nervous system (brain and spinal cord) damage. With the sudden loss of background sympathetic stimulation, the vessels suddenly relax resulting in a sudden decrease in peripheral vascular resistance (vasodilatation) and decreased blood pressure. | Neurogenic shock I Definition Neurogenic shock is shock caused by the sudden loss of the autonomic nervous system signals to the smooth muscle in vessel walls. This can result from severe central nervous system brain and spinal cord damage. With the sudden loss of background sympathetic stimulation the vessels suddenly relax resulting in a sudden decrease in peripheral vascular resistance vasodilatation and decreased blood pressure. Simple fainting syncope is a variation of neurogenic shock. It often is the result of a temporary gravitational pooling of the blood as a person stands up. As the person falls blood again rushes to the head and the problem is solved. Neurogenic shock may also be induced by fear or horror which will override the autonomic nervous system control. Shell shock and bomb shock are other variations of neurogenic shock. These are psychological adjustment reactions to extremely stressful wartime experiences and do not relate to the collapse of the cardiovascular system. Symptoms range from intense fear to complete dementia and are manifestations of a loss of nervous control. II signs and symtoms -hypotension -bradycardia -warm dry extremities -peripheral vasodilation venous pooling -Poikilothermia - Priapism due to PNS stimulation -decreased cardiac output with cervical or high thoracic injury NA JSEA. VOMIT. TH R5T SKIN PALE TO BLUISH COMPLEXION cold clammy PRC FUSE SWEATING EYES PULL pR LACKLUSTER PUPILS DI LATEp BREATHING- Shallow labored RAPI III Diagnosis and differential The diagnosis of neurogenic shock should be one of exclusion. Neurogenic shock must be differentiated from other types of shock particularly hypovolemic. When dealing with a trauma patient one must always assume that any hypotension is a result of ongoing blood loss. A patient suffering from neurogenic shock may also have concomitant injuries which may contribute to hemodynamic instability. Clinical clues such as hypotension bradycardia neurologic dysfunction and warm dry
