Autonomic Dysreflexia-Like Syndrome in a T12 Paraplegic During Thoracic Spine Surgery
WALTER REED ARMY MEDICAL CENTER WASHINGTON DC
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A 19-year-old African American man with a T12 spinal cord lesion underwent a T4-L5 thoracolumbar spinal fusion. Intraoperatively, his arterial blood pressure acutely increased from 11060 to 260130 mm Hg without a change in heart rate. The patient did not have pheochromocytoma, carcinoid syndrome, or thyroid storm. This presentation differs from autonomic dysreflexia because the spinal cord lesion was well below T6, hypertension was elicited with somatic stimulation above the lesion, and the response required aggressive pharmacologic management. This presentation is consistent with similar cases that support a central autonomic process.
- Anatomy and Physiology
- Medicine and Medical Research