Life-threatening outcomes associated with autonomic dysreflexia: a clinical review.

Context Autonomic dysreflexia (AD) is a life-threatening complication of chronic traumatic spinal cord injury (SCI). Objective To document and provide insight into the life-threatening sequelae associated with AD. Methods A review was conducted to identify literature which documented cases of AD associated with life-threatening outcomes (and death). The search strategy comprised of a keyword search on the PubMed database as well as manual searches of retrieved articles. Outcomes were categorized into three main classes: central nervous system (CNS), cardiovascular (CV), and pulmonary. Results Thirty-two cases of death or life-threatening complications of AD were found. Twenty-three (72%) cases were CNS-related, seven (22%) cases were CV-related, and two (6%) cases were pulmonary-related. In total, seven (22%) deaths were noted as a direct result of complications following an AD attack. Conclusion AD is a well-known consequence of SCI among individuals with high thoracic and cervical injuries. Many of these individuals experience this condition on a daily basis. Medical personnel, care givers, and individuals with SCI should be aware of the importance of timely diagnosis and management of this life-threatening condition, which can result in a variety of significant complications including stroke, seizures, myocardial ischemia, and death.

Gravidez em mulheres com trauma medular prévio / Pregnancy on women with previous medullary injury

No Brasil, há 130 mil indivíduos com trauma da medula espinhal e, a cada cinco pessoas vítimas de lesão traumática da medula, uma é mulher. Devido ao trauma da medula espinhal ser menos incidente entre mulheres, e por estas permanecerem férteis e capazes de levar uma gravidez a termo, a literatura tem ignorado grandemente seu estudo ? fato que não elimina as muitas alterações psicofisiológicas, bem como as alterações na sexualidade e outras dificuldades durante a gestação. Apesar disso, os poucos estudos existentes indicam que, nesse caso, o parto normal pode ser vantajoso em relação à cesariana. O objetivo do trabalho foi realizar uma revisão da literatura sobre o assunto, e assim colaborar com os profissionais da área da saúde quanto à atenção à gestante com trauma da medula espinhal

In Brazil, there are 130 thousand individuals with spinal cord injury, and one out of five injured people is a woman. Due to the lower incidence of spinal cord injury among women, and to the fact that they remain fertile and able to carry a pregnancy to term, the literature has largely ignored their study ? a fact which does not exclude the many psycho-physiological changes, as well as alterations in sexuality and other difficulties during pregnancy. Nevertheless, the few existing studies indicate that the normal birth may be advantageous when compared to the cesarean. The objective of the article is to conduct a review of the literature on the subject, and thus collaborate with health care professionals on the attention to pregnant women with spinal cord injury