Cerebral syncope in a patient with spinal cord injury.
An 80-year-old patient suffering from traumatic paraplegia due to spinal cord compression was admitted due to recurrent orthostatic syncope. Tilt table testing revealed that the patient lost consciousness without hypotension. Doppler flow measurements of the middle cerebral arteries showed a significant decrease in diastolic velocity during syncope without systemic hypotension. Treatment with beta-blockers was highly effective. The patient suffered from cerebral blood flow disregulation probably due to abnormal baroreceptor responses triggered during orthostatic stress. This is the first reported case of a patient with spinal cord injury suffering from such an unusual cause of syncope.
Bisharat
Naiel
N
Department of Medicine, Ha'Emek Medical Center, Rappaport Faculty of Medicine-Technion, Afula, Israel. naiel;varannet.com
Paz
Ehud
E
Klimov
Alexander
A
Friedberg
Nahum
N
Elias
Mazen
M
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000368:Aged; D000369:Aged, 80 and over; D002560:Cerebrovascular Circulation / Q000502:physiology*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D010264:Paraplegia / Q000150:complications*; D011433:Propranolol / Q000627:therapeutic use*; D013117:Spinal Cord Compression / Q000150:complications*; D019462:Syncope, Vasovagal / Q000188:drug therapy / Q000209:etiology*; D018667:Tilt-Table Test
D000319:Adrenergic beta-Antagonists; D011433:Propranolol