Autonomic Hyperreflexia: Hemodynamics, Blood Volume, Serum Dopamine-β-Hydroxylase Activity, and Arterial Prostaglandin PGE2

  • N. E. Naftchi
  • M. Demeny
  • M. Berard
  • D. Manning
  • J. Tuckman


The syndrome of autonomic dysreflexia often occurs in quadriplegic subjects and is characterized by paroxysmal hypertension, headache, vasoconstriction below and flushing of the skin above the level of transection, and bradycardia. These attacks may cause hypertensive encephalopathy, cerebral vascular accidents, and death. In five patients during crises, the mean arterial pressure changed from 95 to 154 mmHg, heart rate 72 to 45 beats/min., cardiac output 4.76 to 4.70 litres/min., and peripheral resistance 1650 to 2660 dynes. sec. cm-5. In eight subjects, the control plasma, red cell, and total blood volumes were 19.1, 10.5, and 29.6 ml/cm body height, respectively, and, when hypertensive, the plasma protein concentration increased by 9.9% and the hematocrit by 9.5%. It was estimated that plasma volume was reduced 10–15%. At that time, arterial dopamine-β-hydroxylase (DβH) activity increased 65% and prostaglandin E2 concentration by 68%. Thus, the augmented DβH activity primarily represented elevated sympathetic tone rather than hemoconcentration of that protein. It is also suggested that the rise in prostaglandin may be a contributing cause of the severe headaches during hypertensive episodes.


Cardiac Output Plasma Volume Total Blood Volume Autonomic Dysreflexia Bladder Distension 
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© Spectrum Publications, Inc. 1982

Authors and Affiliations

  • N. E. Naftchi
  • M. Demeny
  • M. Berard
  • D. Manning
  • J. Tuckman

There are no affiliations available

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