American Journal of Emergency Medicine
Volume 17, Issue 3 , Pages 238-240, May 1999

Autonomic dysreflexia presenting as a severe headache

  • William A McClain, MD

      Affiliations

    • From the Department of Emergency Medicine, New York Hospital Medical Center of Queens, Flushing, NY, USA
    • the Division of Emergency Medicine, Department of Medicine, Cornell University Medical College, New York, NY. USA
    • ,
  • Christopher P Shields, MD

      Affiliations

    • From the Department of Emergency Medicine, New York Hospital Medical Center of Queens, Flushing, NY, USA
    • the Division of Emergency Medicine, Department of Medicine, Cornell University Medical College, New York, NY. USA
    • ,
  • Diane M Sixsmith, MD, MPH

      Affiliations

    • Corresponding Author InformationAddress reprint requests to Dr Sixsmith, Department of Emergency Medicine, New York Hospital Medical Center of Queens, 56-45 Main St, Flushing, NY 11355-5095.
    • From the Department of Emergency Medicine, New York Hospital Medical Center of Queens, Flushing, NY, USA
    • the Division of Emergency Medicine, Department of Medicine, Cornell University Medical College, New York, NY. USA

Received 12 March 1997; received in revised form 2 April 1997 and 15 May 1997; accepted 20 June 1997.

Abstract

Hypertension, bradycardia, and severe headache have been associated with autonomic dysreflexia. Autonomic dysreflexia affects those with spinal transection above the level of T6 after plastic changes of the afferent pathways. This restructuring in the presence of noxious stimuli below the level of the lesion leads to autonomic dysreflexia. The onset of the first episode of autonomic dysreflexia has been documented as soon as 30 days and as late as 13 years after the injury. This report presents a case study of a paraplegic man 8 years after injury with autonomic dysreflexia associated with a urinary tract infection.

Keywords: Autonomic dysreflexia, hypertension, headache

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PII: S0735-6757(99)90113-4

American Journal of Emergency Medicine
Volume 17, Issue 3 , Pages 238-240, May 1999
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