- Primary spinal cord injury triggers several secondary injury mechanisms involving vascular compromise leading to
- Reduced blood flow
- Loss of autoregulation
- Loss of microcirculation
- Vasospasm
- Thrombosis
- Haemorrhage
- Acute SCI also causes systemic vascular alteration such as
- Bradycardia (associated more frequently with cervical injuries),
- Cardiac arrhythmias,
- Reduced mean arterial pressure,
- Reduced peripheral vascular resistance,
- Compromised cardiac output.
- Life- threatening cardiovascular instability may be recurrent in the first 7– 10 days after injury.
- Summary of AANS and CNS guidelines for management of SCI
No. | Guideline description |
1 | Management of patients with acute SCI in an intensive care unit or a similarly monitored setting where cardiac, haemodynamic, and respiratory monitoring can be used to detect cardiovascular dysfunction and respiratory insufficiency. |
2 | Avoid systemic hypotension (defined as systolic blood pressure < 90 mmHg) and correction as soon as possible. |
3 | Maintenance of mean arterial blood pressure at 85–90 mmHg for the first seven days following acute SCI to improve spinal cord perfusion. |