Acute Onset of Intracerebral Hemorrhage due to Autonomic Dysreflexia

Autonomic dysreflexia (AD) is a condition where the body has an uncontrolled sympathetic output, often seen in spinal cord injury (SCI) patients with lesions above T6. This can lead to fluctuations in blood pressure and potentially life-threatening hypertensive attacks. The primary management of AD involves identifying and eliminating the triggering factors, with urinary tract obstruction and fecal impaction being the most common. Prompt recognition and treatment are crucial to prevent severe complications. This report presents a case of a SCI patient who experienced a rare hypertensive cerebral hemorrhage as a complication of an AD episode, highlighting the importance of monitoring and managing potential triggers to avoid such devastating outcomes.

• 1
  A patient with a history of spinal cord injury developed right thalamic hemorrhage secondary to autonomic dysreflexia triggered by suprapubic catheter obstruction.
• 2
  Prompt recognition and removal of the urinary catheter obstruction led to a favorable functional outcome for the patient after hematoma resorption and rehabilitation.
• 3
  The case highlights that uncontrolled hypertension from autonomic dysreflexia can lead to severe central nervous system complications, such as intracerebral hemorrhage, even in chronic SCI patients.