title: Intracerebral hemorrhage secondary to autonomic dysreflexia in a young person with incomplete C8 tetraplegia: A case report.
abstract: Intracerebral hemorrhage is an unusual complication of autonomic dysreflexia and can be fatal if massive bleeding occurs with brain herniation. We report the case of a man in his midthirties with incomplete tetraplegia who suffered right putaminal hemorrhage during an episode of autonomic dysreflexia. Prompt recognition and removal of the triggering factors of autonomic dysreflexia quickly brought his blood pressure under control and the patient had a favorable functional outcome after rehabilitation. A review of the literature suggests that the location of hemorrhage in autonomic dysreflexia-induced cases is similar to that in the general population. The most common triggering factors are bladder distension in men and labor induction in women. Hemorrhagic stroke can also occur in patients with incomplete spinal cord injury (SCI) who develop autonomic dysreflexia. The role of sympathetic skin response examination is also discussed. This life-threatening complication should be kept in mind in the case of people with SCI.
authors.affiliation: Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Shin-Liang
authors.initials: SL
authors.lastname: Pan
authors.forename: Yen-Ho
authors.initials: YH
authors.lastname: Wang
authors.forename: Hui-Lin
authors.initials: HL
authors.lastname: Lin
authors.forename: Chein-Wei
authors.initials: CW
authors.lastname: Chang
authors.forename: Ti-Yi
authors.initials: TY
authors.lastname: Wu
authors.forename: Eou-Ting
authors.initials: ET
authors.lastname: Hsieh
mesh_terms: D000328:Adult; D020211:Autonomic Dysreflexia / Q000150:complications* / Q000503:physiopathology / Q000534:rehabilitation; D002543:Cerebral Hemorrhage / Q000209:etiology*; D006801:Humans; D008297:Male; D011782:Quadriplegia; D013119:Spinal Cord Injuries / Q000150:complications*