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NEUROGENIC SHOCK
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DEFINITION OF NEUROGENIC
Neurogenic:
- Starting with or having to do with the nerves or
the nervous system.
- A contraction that occurs in response to anervous
stimulus.
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NEUROGENIC BLADDER
The muscles and nerves of the urinarysystem or! to"ether
to hold urine in the#ladder and then release it at the
a$$ro$riatetime%
Nerves carry messa"es from the #ladder tothe #rain and from the
#rain to the musclesof the #ladder tellin" them either to ti"htenor
release%
In a neuro"enic #ladder& the nerves that are
su$$osed to carry these messa"es do not
or! $ro$erly%
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COMPLICATIONS OF A NEUROGENICBLADDER:
1. Urine leakage' Often occurs hen themuscles holdin" urine in
do not "et the ri"htmessa"e%
2. Urine retention' Often ha$$ens if the
muscles holdin" urine in do not "et themessa"e that it is time
to let "o%
3. Damage to the tiny blood vessels in thekidney ' Often
ha$$ens if the #ladder#ecomes too full and urine #ac!s u$ into
the!idneys& causin" e(tra $ressure%
4. Infection of the bladder or ureters' Oftenresults from urine
that is held too lon" #efore#ein" eliminated%
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WHAT CAUSES NEUROGENIC BLADDER?
The folloin" are $ossi#le causes ofneuro"enic #ladder'
)% Dia#etes
*% Acute infection+% Accidents that cause trauma to the #rainor
s$inal
cord%
,% Genetic nerve $ro#lems-% .eavy metal $oisonin"
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SYMPTOMS OF NEUROGENICBLADDER
Each individual may e($erience sym$toms di/erently% 0ym$tomsEach
individual may e($erience sym$toms di/erently% 0ym$toms
may include'may include'
)% urinary tract infection)% urinary tract infection
*% 1idney stones 2 these may #e di3cult to determine #ecause
you*% 1idney stones 2 these may #e di3cult to determine #ecause
you
may not #e a#le to feel $ain associated ith !idney stones if
youmay not #e a#le to feel $ain associated ith !idney stones if
you
have s$inal cord a#normalities% 0ym$toms of !idney stoneshave
s$inal cord a#normalities% 0ym$toms of !idney stones
include'include' chillschills
shiverin"shiverin"
feverfever
+% Urinary incontinence+% Urinary incontinence
,% 0mall urine volume durin" voidin",% 0mall urine volume durin"
voidin"
-% Urinary fre4uency and ur"ency-% Urinary fre4uency and
ur"ency
5% Dri##lin" urine5% Dri##lin" urine
6% Loss of sensation of #ladder fullness6% Loss of sensation of
#ladder fullness
The sym$toms of neuro"enic #ladder may resem#le
other The sym$toms of neuro"enic #ladder may resem#le
other
conditions and medical $ro#lems% Alays consult your
$hysicianconditions and medical $ro#lems% Alays consult your
$hysician
for a dia"nosis%for a dia"nosis%
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HOW IS NEUROGENIC BLADDERDIAGNOSED?
7hen neuro"enic #ladder is sus$ected& #oththe nervous system
8includin" the #rain9 andthe #ladder itself are e(amined% In
addition toa com$lete medical history and $hysical
e(amination& dia"nostic $rocedures forneuro"enic #ladder may
include the folloin"'
)% (2rays of the s!ull and
*% electroence$halo"ram 8EEG9
+% Ima"in" tests of the #ladder and ureters,% Tests that involve
:llin" the #ladder 8to seeho much it can hold and chec!in" to see
ifthe #ladder em$ties com$letely9
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TREATMENT FOR NEUROGENICBLADDER
0$eci:c treatment for neuro"enic #ladder ill #e determined #y
your $hysician0$eci:c treatment for neuro"enic #ladder ill #e
determined #y your $hysician#ased on'#ased on'
)% A"e& overall health& and medical history)% A"e&
overall health& and medical history
*% 0everity of sym$toms*% 0everity of sym$toms
+% Cause of the nerve dama"e+% Cause of the nerve dama"e
,% Ty$e of voidin" dysfunction that results,% Ty$e of voidin"
dysfunction that results
-% ;our tolerance for s$eci:c medications& $rocedures&
or thera$ies-% ;our tolerance for s$eci:c medications&
$rocedures& or thera$ies
5% E($ectations for the course of the condition5% E($ectations
for the course of the condition
6% ;our o$inion or $reference6% ;our o$inion or $reference
Treatment may include' Treatment may include'
)% Insertion of a catheter or hollo tu#e 8to em$ty the #ladder
at re"ular intervals9)% Insertion of a catheter or hollo tu#e 8to
em$ty the #ladder at re"ular intervals9
*%
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NEUROGENIC SHOCK
Neurogeni !"o# is shoc! caused #y the
sudden loss of the autonomic nervoussystem si"nals to the smooth
muscle invessel alls%
Result from severe central nervous system
8#rain and s$inal cord9 dama"e% 7ith thesudden loss of
#ac!"round sym$atheticstimulation& the vessels suddenly
rela(resultin" in a sudden decrease in $eri$heralvascular
resistance 8vasodilation9 anddecreased #lood $ressure%
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SIGNS AND SYMPTOMS
•
.y$otension• Bradycardia
• 7arm& dry e(tremities
•
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NEUROGENIC SHOCK
If $ossi#le treat $atient in Trendelen#ur" $osition%Lar"e
volumes of =uid may #e
needed to restore normalhemodynamics
Do$amine 8Intro$in9 is often usedeither alone or in com#ination
ith
other inotro$ic a"ents%?aso$ressors 8E$hedrine9Atro$ine 8s$eeds
u$ heart rate and
Cardiac Out$ut9
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