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Kim T, Jwa CS. Effect of Alpha-1-Adrenergic Agonist, Midodrine for the Management of Long-Standing Neurogenic Shock in Patient with Cervical Spinal Cord Injury: A Case Report. Korean J Neurotrauma. 2015;11(2):147-50doi: 10.13004/kjnt.2015.11.2.147.
Kim, T., & Jwa, C. S. (2015). Effect of Alpha-1-Adrenergic Agonist, Midodrine for the Management of Long-Standing Neurogenic Shock in Patient with Cervical Spinal Cord Injury: A Case Report. Korean journal of neurotrauma, 11(2), 147-50. https://doi.org/10.13004/kjnt.2015.11.2.147
Kim, Taikwan, and Jwa, Cheol Su. "Effect of Alpha-1-Adrenergic Agonist, Midodrine for the Management of Long-Standing Neurogenic Shock in Patient with Cervical Spinal Cord Injury: A Case Report." Korean journal of neurotrauma vol. 11,2 (2015): 147-50. doi: https://doi.org/10.13004/kjnt.2015.11.2.147
Kim T, Jwa CS. Effect of Alpha-1-Adrenergic Agonist, Midodrine for the Management of Long-Standing Neurogenic Shock in Patient with Cervical Spinal Cord Injury: A Case Report. Korean J Neurotrauma. 2015 Oct;11(2):147-50. doi: 10.13004/kjnt.2015.11.2.147. Epub 2015 Oct 31. PMID: 27169082; PMCID: PMC4847524.
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Korean J Neurotrauma. 2015 Oct;11(2):147-50. doi: 10.13004/kjnt.2015.11.2.147. Epub 2015 Oct 31.

Effect of Alpha-1-Adrenergic Agonist, Midodrine for the Management of Long-Standing Neurogenic Shock in Patient with Cervical Spinal Cord Injury: A Case Report.

Korean journal of neurotrauma

Taikwan Kim, Cheol Su Jwa

Affiliations

  1. Department of Neurosurgery, National Medical Center, Seoul, Korea.

PMID: 27169082 PMCID: PMC4847524 DOI: 10.13004/kjnt.2015.11.2.147

Abstract

We report a rare case of a 71-year-old male patient who had suffered from long-lasting neurogenic shock for 13 weeks after cervical spinal cord injury (SCI) caused by a bicycle accident. The neurogenic shock was resolved dramatically 2 weeks after the administration of alpha-1-adrenergic agonist, midodrine hydrochloride. In usual cases, neurogenic shock tends to improve between 2 and 6 weeks after SCI; however, in a few cases, the shock lasts for several months. In our case, spinal shock lasted for 13 weeks and exhibited very sensitive decline of blood pressure for even a slight decrease of dopamine despite recovered bulbospongiosus reflex. Three days after midodrine hydrochloride was added, hypotension improved dramatically. We discuss our rare case with pertinent literatures.

Keywords: Adrenergic alpha-agonists; Hypotension; Midodrine; Spinal cord injuries

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