Autonomic dysreflexia occurs in spinal cord injuries at or above which level?

Autonomic dysreflexia occurs in spinal cord injuries at or above which level?

• A. T6 and above
• B. T12 and above
• C. C7 and above
• D. L1 and above

Answer: (A)

Autonomic dysreflexia happens when a spinal cord injury disrupts the brain’s ability to modulate autonomic reflexes below the level of injury. When the injury is at or above the T6 level, descending inhibitory signals can no longer reach the sympathetic neurons below that point. A noxious or distending stimulus below the injury, such as bladder fullness or bowel impaction, triggers a massive, unregulated sympathetic discharge. This causes widespread vasoconstriction below the level of injury and a dangerous rise in blood pressure. The body’s parasympathetic response can try to act above the injury (leading to sweating or flushing there), but it cannot reverse the severe vasoconstriction below the injury. Because a large portion of the body’s sympathetic tone lies in the splanchnic vascular bed, injuries at or above T6 permit this reflex to produce a life-threatening hypertension, which is why this level is the threshold. Manage by removing the trigger (e.g., catheterize, relieve obstruction) and position the patient upright to help lower blood pressure, then monitor and treat as needed.

Autonomic dysreflexia happens when a spinal cord injury disrupts the brain’s ability to modulate autonomic reflexes below the level of injury. When the injury is at or above the T6 level, descending inhibitory signals can no longer reach the sympathetic neurons below that point. A noxious or distending stimulus below the injury, such as bladder fullness or bowel impaction, triggers a massive, unregulated sympathetic discharge. This causes widespread vasoconstriction below the level of injury and a dangerous rise in blood pressure. The body’s parasympathetic response can try to act above the injury (leading to sweating or flushing there), but it cannot reverse the severe vasoconstriction below the injury. Because a large portion of the body’s sympathetic tone lies in the splanchnic vascular bed, injuries at or above T6 permit this reflex to produce a life-threatening hypertension, which is why this level is the threshold. Manage by removing the trigger (e.g., catheterize, relieve obstruction) and position the patient upright to help lower blood pressure, then monitor and treat as needed.