A patient with a history of spinal cord injury at the T4 level presents to the hospital in labor at 37 weeks’ gestation. Which of the following is the most likely associated sign or symptom of autonomic hyperreflexia in this patient?
Autonomic hyperreflexia, also called autonomic dysreflexia, is a life-threatening complication of spinal cord injury in patients who have chronic spinal cord lesions at or above the T5-6 level. Afferent noxious or painful stimuli originating below the level of the spinal cord lesion enter the dorsal horn of the cord and are propagated within the sympathetic chain in both cephalad and caudad directions.
Because there is loss of central inhibition, an extreme sympathetic nervous system response at and below the level of the spinal cord lesion leads to significant vasoconstriction and hypertension. Baroreceptors in the aortic and carotid bodies initiate a reflex response that can cause bradycardia as well as...
