title: Effect of Alpha-1-Adrenergic Agonist, Midodrine for the Management of Long-Standing Neurogenic Shock in Patient with Cervical Spinal Cord Injury: A Case Report.
abstract: We report a rare case of a 71-year-old male patient who had suffered from long-lasting neurogenic shock for 13 weeks after cervical spinal cord injury (SCI) caused by a bicycle accident. The neurogenic shock was resolved dramatically 2 weeks after the administration of alpha-1-adrenergic agonist, midodrine hydrochloride. In usual cases, neurogenic shock tends to improve between 2 and 6 weeks after SCI; however, in a few cases, the shock lasts for several months. In our case, spinal shock lasted for 13 weeks and exhibited very sensitive decline of blood pressure for even a slight decrease of dopamine despite recovered bulbospongiosus reflex. Three days after midodrine hydrochloride was added, hypotension improved dramatically. We discuss our rare case with pertinent literatures.
authors.affiliation: Department of Neurosurgery, National Medical Center, Seoul, Korea.
authors.forename: Taikwan
authors.initials: T
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, National Medical Center, Seoul, Korea.
authors.forename: Cheol Su
authors.initials: CS
authors.lastname: Jwa
keywords: Adrenergic alpha-agonists; Hypotension; Midodrine; Spinal cord injuries