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Abstract
Context
Autonomic dysreflexia (AD) is a life-threatening complication of chronic traumatic spinal cord injury (SCI).
Objective
To document and provide insight into the life-threatening sequelae associated with AD.
Methods
A review was conducted to identify literature which documented cases of AD associated with life-threatening outcomes (and death). The search strategy comprised of a keyword search on the PubMed database as well as manual searches of retrieved articles. Outcomes were categorized into three main classes: central nervous system (CNS), cardiovascular (CV), and pulmonary.
Results
Thirty-two cases of death or life-threatening complications of AD were found. Twenty-three (72%) cases were CNS-related, seven (22%) cases were CV-related, and two (6%) cases were pulmonary-related. In total, seven (22%) deaths were noted as a direct result of complications following an AD attack.
Conclusion
AD is a well-known consequence of SCI among individuals with high thoracic and cervical injuries. Many of these individuals experience this condition on a daily basis. Medical personnel, care givers, and individuals with SCI should be aware of the importance of timely diagnosis and management of this life-threatening condition, which can result in a variety of significant complications including stroke, seizures, myocardial ischemia, and death.
Acknowledgement
Mr Wan is a recipient of the University of British Columbia Summer Student Research Program – Mach-Gaensslen Foundation scholarship. Dr Andrei Krassioukov's research is supported by grants from the Canadian Institute for Health Research (CIHR) and the Heart and Stroke Foundation of Canada. We acknowledge Dr Vanessa Noonan and Gina Zhong from the Rick Hansen Institute for assistance with statistical analysis. Finally, Dr David Whitehurst from Simon Fraser University is acknowledged for his editorial comments.