Cervical spinal cord injury presenting with refractory orthostatic hypotension: a case report

Abstract

In case of cervical and upper thoracic spinal cord injuries, refractory orthostatic hypotension may result from unmeet parasympathetic system influences and sympathetic system impairment due to the diffuse destruction of the sympathetic innervation of the body and the preservation of parasympathetic cranial innervation in certain patients. Pharmacological treatments include mineralocorticoids and adrenergic agents, while non-pharmacological methods such as abdominal pads and compression devices can be used. Herein, we report a 21-year-old male case of refractory orthostatic hypotension following a fifth cervical vertebra compression fracture. The case was treated with mineralocorticoid therapy in conjunction with electrical stimulation to the quadriceps and tibialis anterior muscles. The results of the treatment and treatment strategies of orthostatic hypotension are discussed in the light of literature data.