II. Pathophysiology

  1. Results from Severe Head Injury
  2. Peripheral sympathetic denervation (ungoverned parasympathetic activity)

III. Signs

  1. Hypotension
    1. Secondary to Bradycardia and vasodilation
  2. Bradycardia
  3. Decreased vascular tone (vasodilation)
    1. Warm extremities

IV. Differential Diagnosis

  1. Hemorrhagic Shock (first priority to manage)
    1. Presents with Tachycardia, Vasoconstriction and cold extremities
    2. In actuality, distinguishing from Neurogenic Shock can be difficult
    3. Hemorrhagic Shock is more common, more immediately deadly and more treatable and should be addressed first

V. Pitfalls

  1. Fluid Overload (from aggressive fluid Resuscitation)

VI. Management

  1. Careful Fluid Replacement
  2. Pressors (Norepinephrine is preferred)
  3. Target mean arterial pressure of 85 mmHg or higher (maximizes spinal cord perfusion)

VII. Prognosis

  1. Neurogenic Shock is a critcial Head Injury to the point of terminal event
  2. Prognosis is often poor

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Ontology: Neurogenic shock (disorder) (C0544617)

Definition (NCI_FDA) Shock resulting from neurogenic vasodilation, which can be produced by cerebral trauma or hemorrhage, spinal cord injury, deep general or spinal anesthesia, or toxic central nervous system depression.
Definition (NCI) Shock resulting from neurogenic vasodilation, which can be produced by cerebral trauma or hemorrhage, spinal cord injury, deep general or spinal anesthesia, or toxic central nervous system depression.
Concepts Pathologic Function (T046)
SnomedCT 129577007
Italian Shock neurogeno
English Vasogenic Shock, Neurogenic Shock, Neurogenic shock (disorder), neurogenic shock, SHOCK, NEUROGENIC, NEUROGENIC SHOCK, shock neurogenic, Neurogenic shock (diagnosis), Neurogenic shock
Japanese 神経原性ショック, シンケイゲンセイショック
Czech Neurogenní šok
Hungarian Neurogen shock
Spanish choque neurogénico, choque neurógeno (trastorno), choque neurógeno, shock neurogénico, shock neurógeno, Shock neurogénico
Portuguese Shock neurogénico
Dutch neurogene shock
French Choc neurogène
German neurogener Schock