PDF(Pubmed)
Abstract：
Autonomic dysreflexia (AD), a condition of critically raised blood pressure, is a severe complication of spinal cord injury. Primary (essential) hypertension may present with similar blood pressure levels to AD, though the causes, pathophysiology, presentation and treatment will differ.
We report a case of a 74-year-old patient with a C1 spinal injury, who developed primary (essential) hypertension during her rehabilitation phase of care, requiring extensive investigations for autonomic dysreflexia. Despite this, no underlying cause was found; essential hypertension was subsequently confirmed with 24-hour ambulatory blood pressure monitoring. Treatment with an ACE inhibitor was introduced to good effect.
Essential hypertension can affect patients with spinal injury, even though most patients with higher level injuries (particularly cervical spinal cord injuries) are expected to have low resting baseline hypotension. Relevant features of this are presented within this case; a set of criteria to differentiate essential hypertension from autonomic dysreflexia are also proposed.
We report a case of a 74-year-old patient with a C1 spinal injury, who developed primary (essential) hypertension during her rehabilitation phase of care, requiring extensive investigations for autonomic dysreflexia. Despite this, no underlying cause was found; essential hypertension was subsequently confirmed with 24-hour ambulatory blood pressure monitoring. Treatment with an ACE inhibitor was introduced to good effect.
Essential hypertension can affect patients with spinal injury, even though most patients with higher level injuries (particularly cervical spinal cord injuries) are expected to have low resting baseline hypotension. Relevant features of this are presented within this case; a set of criteria to differentiate essential hypertension from autonomic dysreflexia are also proposed.
摘要：
背景：自主神经反射异常（AD），血压严重升高，是脊髓损伤的严重并发症。原发性（原发性）高血压可能存在与AD相似的血压水平，虽然原因，病理生理学,介绍和治疗会有所不同。
方法：我们报告一例74岁的C1脊髓损伤患者，在康复护理阶段出现原发性（原发性）高血压，需要对自主神经反射异常进行广泛的调查。尽管如此,未发现根本原因;随后通过24小时动态血压监测证实了原发性高血压.引入ACE抑制剂的治疗效果良好。
结论：原发性高血压可影响脊髓损伤患者，即使大多数高水平损伤（尤其是颈脊髓损伤）的患者预计静息基线低血压。这种情况下具有相关特征；还提出了一套区分原发性高血压和自主神经反射异常的标准。
方法：我们报告一例74岁的C1脊髓损伤患者，在康复护理阶段出现原发性（原发性）高血压，需要对自主神经反射异常进行广泛的调查。尽管如此,未发现根本原因;随后通过24小时动态血压监测证实了原发性高血压.引入ACE抑制剂的治疗效果良好。
结论：原发性高血压可影响脊髓损伤患者，即使大多数高水平损伤（尤其是颈脊髓损伤）的患者预计静息基线低血压。这种情况下具有相关特征；还提出了一套区分原发性高血压和自主神经反射异常的标准。
