Neurogenic Shock

High spinal cord injuries can also result in systemic hypotension because of loss of sympathetic tone. The patient will usually have hypotension and relative bradycardia and will show evidence of good peripheral perfusion on physical examination. The term neurogenic shock is used but is somewhat of a misnomer because these patients are typically hyperdynamic, with high cardiac output secondary to loss of sympathetic vascular tone.

After hemorrhagic causes of hypotension have been ruled out, the hypotension associated with high spinal injury can be treated by the administration of an a-agonist such as phenylephrine.