Spinal Cord Injury (SCI) results in significant cardiovascular autonomic dysfunction
dependent on the level and completeness of lesion. Impaired cardiovascular control
in SCI is associated with loss of sympathetic neural control of the heart and vasculature
and can result in precipitous variations in blood pressure, such as Orthostatic Hypotension
and Autonomic Dysreflexia. Individuals with SCI are at higher risk of cerebrovascular
disease, such as stroke and transient ischemic attacks. Cerebral blood flow (CBF)
is thought to remain relatively constant within a range of blood pressures, known
as cerebral autoregulation (CA) which comprises two components; static and dynamic
CA. Cerebral blood flow is also modulated by adjustments in systemic hemodynamics
(i.e., perfusion pressure and sympathetic nerve activity) and arterial carbon dioxide
content (pCO2; cerebrovascular CO2 reactivity). Limited research on CBF control in SCI indicates that static CA is maintained
but subtle improvements in dynamic CA may occur. Similarly, reports of altered cerebrovascular
CO2 reactivity in SCI are equivocal but subtle improvements may occur.
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Publication history
Received:
May 15,
2013
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Copyright
© 2013 Published by Elsevier Inc.
