NEUROGEN

IC SHOCK

DEFINITION OF NEUROGENIC

Neurogenic:
- Starting with or having to do with the nerves or
the nervous system.
- A contraction that occurs in response to a
nervous stimulus.

NEUROGENIC BLADDER
The muscles and nerves of the urinary
system work together to hold urine in the
bladder and then release it at the appropriate
time.
Nerves carry messages from the bladder to
the brain and from the brain to the muscles
of the bladder telling them either to tighten
or release.
In a neurogenic bladder, the nerves that are
supposed to carry these messages do not
work properly.

COMPLICATIONS OF A NEUROGENIC
BLADDER:
1.

2.

3.

4.

Urine leakage: Often occurs when the

muscles holding urine in do not get the right
message.
Urine retention: Often happens if the
muscles holding urine in do not get the
message that it is time to let go.
Damage to the tiny blood vessels in the
kidney: Often happens if the bladder
becomes too full and urine backs up into the
kidneys, causing extra pressure.
Infection of the bladder or ureters: Often
results from urine that is held too long before
being eliminated.

WHAT CAUSES NEUROGENIC BLADDER?

The following are possible causes of

neurogenic bladder:
1. Diabetes
2. Acute infection
3. Accidents that cause trauma to the brain
or spinal
cord.
4. Genetic nerve problems
5. Heavy metal poisoning

SYMPTOMS OF NEUROGENIC
BLADDER

Each individual may experience symptoms differently. Symptoms

may include:
1. urinary tract infection
2. Kidney stones - these may be difficult to determine because you
may not be able to feel pain associated with kidney stones if you
have spinal cord abnormalities. Symptoms of kidney stones
include:
chills
shivering
fever
3. Urinary incontinence
4. Small urine volume during voiding
5. Urinary frequency and urgency
6. Dribbling urine
7. Loss of sensation of bladder fullness

The symptoms of neurogenic bladder may resemble other

conditions and medical problems. Always consult your physician
for a diagnosis.

HOW IS NEUROGENIC BLADDER

DIAGNOSED?

When neurogenic bladder is suspected, both

the nervous system (including the brain) and
the bladder itself are examined. In addition to
a complete medical history and physical
examination, diagnostic procedures for
neurogenic bladder may include the following:
1. x-rays of the skull and
2. electroencephalogram (EEG)
3. Imaging tests of the bladder and ureters
4. Tests that involve filling the bladder (to see
how much it can hold and checking to see if
the bladder empties completely)

TREATMENT FOR NEUROGENIC

BLADDER

Specific treatment for neurogenic bladder will be determined by your physician

based on:
1. Age, overall health, and medical history
2. Severity of symptoms
3. Cause of the nerve damage
4. Type of voiding dysfunction that results
5. Your tolerance for specific medications, procedures, or therapies
6. Expectations for the course of the condition
7. Your opinion or preference

Treatment may include:

1. Insertion of a catheter or hollow tube (to empty the bladder at regular intervals)
2. Prophylactic (preventive) antibiotic therapy (to reduce the incidence of
infection)
3. Placement of an artificial sphincter - procedure involves placing an artificial cuff
around the neck of the bladder that can be inflated to prevent urinary
incontinence and deflated when it is time to empty the bladder. You will still
require intermittent catheterization to completely empty the bladder.
4. Surgery

NEUROGENIC SHOCK
Neurogenic shock is shock caused by the
sudden loss of the autonomic nervous
system signals to the smooth muscle in
vessel walls.
Result from severe central nervous system
(brain and spinal cord) damage. With the
sudden loss of background sympathetic
stimulation, the vessels suddenly relax
resulting in a sudden decrease in peripheral
vascular resistance (vasodilation) and
decreased blood pressure.

SIGNS AND SYMPTOMS

Hypotension
Bradycardia
Warm, dry extremities
Peripheral vasodilation
Venous pooling
Poikilothermia
Priapism: Due to PNS stimulation
Decreased cardiac output (with cervical or
high thoracic injury)

TREATMENT OF
NEUROGENIC SHOCK
If

possible treat patient in

Trendelenburg position.
Large volumes of fluid may be
needed to restore normal
hemodynamics
Dopamine (Intropin) is often used
either alone or in combination with
other inotropic agents.
Vasopressors (Ephedrine)
Atropine (speeds up heart rate and
Cardiac Output)