Abstract
BackgroundAutonomic dysreflexia (AD) is an abnormal reflex of the autonomic nervous system normally observed in patients with spinal cord injury from the sixth thoracic vertebra and above. AD causes various symptoms including paroxysmal hypertension due to stimulus. Here, we report a case of recurrent AD associated with cervical spinal cord tumor.Case presentationThe patient was a 57-year-old man. Magnetic resonance imaging revealed an intramedullary lesion in the C2, C6, and high Th12 levels. During the course of treatment, sudden loss of consciousness occurred together with abnormal paroxysmal hypertension, marked facial sweating, left upward conjugate gaze deviation, ankylosis of both upper and lower extremities, and mydriasis. Seizures repeatedly occurred, with symptoms disappearing after approximately 30 min. AD associated with cervical spinal cord tumor was diagnosed. Histological examination by tumor biopsy confirmed the diagnosis of gliofibroma. Radiotherapy was performed targeting the entire brain and spinal cord. The patient died approximately 3 months after treatment was started.ConclusionsAD is rarely associated with spinal cord tumor, and this is the first case associated with cervical spinal cord gliofibroma. AD is important to recognize, since immediate and appropriate response is required.
Highlights
Autonomic dysreflexia (AD) is an abnormal reflex of the autonomic nervous system normally observed in patients with spinal cord injury from the sixth thoracic vertebra and above
AD is rarely associated with spinal cord tumor, and this is the first case associated with cervical spinal cord gliofibroma
Autonomic dysreflexia (AD) is an abnormal reflex of the autonomic nervous system that is primarily observed in patients with spinal cord injury located at the sixth thoracic vertebra and above [1]
Summary
Autonomic dysreflexia (AD) is an abnormal reflex of the autonomic nervous system that is primarily observed in patients with spinal cord injury located at the sixth thoracic vertebra and above [1]. Postadmission course On the day after admission, the patient suddenly lost consciousness and systolic blood pressure rose to around 230 mmHg, with marked facial sweating, upper conjugate deviation of the left eye, ankylosis of both upper and lower limbs, and dilated pupils. His head was immediately elevated and head computed tomography/magnetic resonance imaging was performed but found no abnormalities. Conjugate deviation of the eye and ankylosis in both upper and lower extremities were alleviated, but the hypertension, facial sweating, and dilated pupils showed almost no improvement These symptoms gradually disappeared after approximately 30 min to one hour, and the patient’s consciousness disturbance was ameliorated. Histopathological findings Tumor cells with short spindle-shaped nuclei and eosinophilic cytoplasm proliferated in bundles, forming an intricate pattern along with collagenous fibrous
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