[Autonomic dysreflexia: a life-threatening complication in patients with a high-level spinal cord injury].

A 37-year-old patient with a traumatic spinal cord injury at the level CVI is described, suffering from a urinary tract infection which was complicated by autonomic dysreflexia. Autonomic dysreflexia occurs only in patients with a spinal cord injury at TVI or above. A variety of afferent stimuli (mostly emerging from bladder or bowel) can induce an uncontrolled sympathetic reaction of the spinal cord below the laesion level that is isolated from the vasomotor centre. This reaction induces vasoconstriction below the laesion. Compensating mechanisms are insufficient to compensate for the vasoconstriction below the laesion. As a result there is a fast rise in blood pressure up to extreme values with a serious risk of cardiac and cerebral complications. Knowledge of these phenomena as well as of the preventive and therapeutic measures is essential since the prevalence of spinal cord injury patients in the population is increasing.