scholarly journals Cerebral Hemorrhage Due to Posterior Reversible Encephalopathy Syndrome Associated With Autonomic Dysreflexia in a Spinal Cord Injury Patient

2012 ◽  
Vol 52 (9) ◽  
pp. 640-643 ◽  
Author(s):  
Tae YAMASHITA ◽  
Hisaya HIRAMATSU ◽  
Naoto SAKAI ◽  
Hiroki NAMBA
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Cerebral Hemorrhage ◽  
Spinal Cord Injury Patient ◽  
Autonomic Dysreflexia ◽  
Posterior Reversible Encephalopathy ◽  
Cord Injury ◽  
Injury Patient ◽  
Reversible Encephalopathy

scholarly journals Possible Role of Large Fluid Intake in Delaying Formation of Encrustations and, thereby, Prolonging Working Life of Memokath Stent for Nearly 14 Years in a Spinal Cord Injury Patient

2007 ◽  
Vol 7 ◽  
pp. 1663-1669 ◽  
Author(s):  
Subramanian Vaidyanathan ◽  
Bakul M. Soni ◽  
Peter L. Hughes ◽  
Gupreet Singh
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Fluid Intake ◽  
Stone Formation ◽  
Outlet Obstruction ◽  
Spinal Cord Injury Patient ◽  
Autonomic Dysreflexia ◽  
Detrusor Sphincter Dyssynergia ◽  
Cord Injury ◽  
Injury Patient

The Memokath stent has been used in spinal cord injury patients as a reversible alternative to external urethral sphincterotomy, but the stent has a finite lifetime of <2 years before failure in the majority of patients. We report an unusual case of a spinal cord injury patient in whom memokath stent was functioning for almost 14 years. The long life span of the Memokath in this patient was probably due to this person's habit of drinking around 5 l of fluids a day. Large fluid intake resulted in high urine output and, consequently, deceased the risk of urine infections and delayed formation of encrustations around the stent. Although this case represents an unusual length of time for a Memokath stent to have been in place and functioning, caution should be exercised against the long-term use of Memokath stents. Memokath stents do not get absorbed into the mucosa unlike urolume stents and, therefore, are prone to stone formation. Further, Memokath stents have not yet been approved in the U.S. either for bladder outlet obstruction or detrusor-sphincter dyssynergia. This case is also a reminder to health professionals that if a tetraplegic patient, in whom a Memokath stent has been deployed for treatment of detrusor-sphincter dyssynergia, presents with autonomic dysreflexia, encrustations blocking the lumen of the stent or calculus formation around the stent should be considered as possible reasons for autonomic dysreflexia.

scholarly journals Intravesical Botulinum Toxin for Persistent Autonomic Dysreflexia in a Pediatric Patient

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Gina Lockwood ◽  
Charles Durkee ◽  
Travis Groth
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Botulinum Toxin ◽  
Treatment Options ◽  
Retrospective Chart Review ◽  
Spinal Cord Injury Patient ◽  
Autonomic Dysreflexia ◽  
Cord Injury ◽  
Pediatric Spinal Cord Injury ◽  
Injury Patient

Introduction. We present a novel case of persistent autonomic dysreflexia in a pediatric spinal cord injury patient treated successfully with intravesical botulinum toxin.Study Design. A retrospective chart review of one patient seen at the Children’s Hospital of Wisconsin from 2006 to 2012 was performed.Results. A pediatric spinal cord injury patient with known neurogenic bladder presented with severe hypertension consistent with autonomic dysreflexia. His symptoms and hypertension did not improve with conservative measures, and he necessitated ICU admission and antihypertensive drips. He was taken to the operating room for intravesical botulinum toxin for refractory bladder spasms. Following this, his symptoms abated, and he was weaned off IV antihypertensives and returned to his baseline state. His symptoms were improved for greater than six months.Conclusions. There are few treatment options for the management of refractory autonomic dysreflexia. Intravesical botulinum toxin has never been reported for this use. Dedicated research is warranted to assess its efficacy, as it was used successfully to abort autonomic dysreflexia in this patient.

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