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- Karlsson, Ann-Katrin, 1950
(författare)
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Autonomic dysfunction in spinal cord injury: clinical presentation of symptoms and signs
- 2006
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Ingår i: Progress in Brain Research. - 0079-6123. ; 152, s. 1-8
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Forskningsöversikt (refereegranskat)abstract
- Spinal cord injury and especially cervical spinal cord injury implies serious disturbances in autonomic nervous system function. The clinical effects of these disturbances are striking. In the acute phase, the autonomic imbalance and its effect on cardiovascular, respiratory system and temperature regulation may be life threatening. Serious complications such as over-hydration with the risk of pulmonary edema or hyponatremia are seen. The cord-injured person suffers from autonomic nervous system dysfunction also affecting bladder and bowel control, renal and sexual function. Paralytic ileus may cause vomiting and aspiration, which in turn interferes with respiratory function in those with cervical spinal cord injury. The cord-injured person is at risk to develop pressure sores from the moment of the accident. Two to three months post-injury the cord-injured person with a lesion level above the fifth thoracic segment may develop autonomic dysreflexia, characterised by sympathetically mediated vasoconstriction in muscular, skin, renal and presumably gastrointestinal vascular beds induced by an afferent peripheral stimulation below lesion level. The reaction might cause cerebrovascular complications and has effects on metabolism. Some of the autonomic disturbances are transient and a new balance is reached months post-injury, while others persist for life.
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| 2. |
- Pazooki, David, 1958, et al.
(författare)
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Continent cutaneous urinary diversion in patients with spinal cord injury.
- 2006
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Ingår i: Spinal cord : the official journal of the International Medical Society of Paraplegia. - : Springer Science and Business Media LLC. - 1362-4393. ; 44:1, s. 19-23
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Tidskriftsartikel (refereegranskat)abstract
- STUDY DESIGN: Retrospective study. OBJECTIVE: To examine the functional results and effect on quality of life of continent cutaneous urinary diversion in spinal cord injured patients. SETTING: Department of Urology, Sahlgrenska University Hospital, Göteborg, Sweden. SUBJECTS: A total of 10 patients with spinal cord injury (SCI). METHOD: The patients were operated on with an ileal reservoir (Kock reservoir or T-pouch), Cr-EDTA clearance was determined preoperatively and at follow-up. The patients answered a questionnaire concerning reservoir function, various activities and quality of life. The patient charts were reviewed. RESULTS: One patient died of pulmonary embolism 3 years after surgery. Two patients were reoperated on for reservoir perforation. All patients were satisfied/very satisfied with their reservoirs. Half of them reported improved ability to perform various activities. Eight out of nine patients reported improved quality of life. CONCLUSION: For a selected group of patients with SCI, continent cutaneous urinary diversion provides successful outcome with improved quality of life.
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