An 18-year-old patient is at risk for certain complications in the first 24 hours after a cervical spine injury. The most likely combination is:

An 18-year-old patient is at risk for certain complications in the first 24 hours after a cervical spine injury. The most likely combination is:

• A. Hypothermia, hypotension, pulmonary edema
• B. Fever, hypertension
• C. Fever, hypotension, hypoglycemia
• D. Autonomic hyperreflexia

Answer: (A)

High cervical spinal injury disrupts the sympathetic nervous system, leading to neurogenic shock. Losing sympathetic tone causes widespread vasodilation and pooling of blood, which produces hypotension. The heart’s accelerators are blunted, so bradycardia often accompanies the hypotension. Thermoregulation also falters because the hypothalamic control of heat loss and production relies on sympathetic pathways, making hypothermia common in the acute phase. Additionally, the injured autonomic axis can drive neurogenic pulmonary edema early, as fluid shifts and capillary leak develop in the lungs. Autonomic hyperreflexia is more typical later, after spinal shock has resolved, and fever with hypertension are not the hallmark features of the first 24 hours. So the combination of hypothermia, hypotension from neurogenic shock, and possible neurogenic pulmonary edema best fits the early period after a cervical spine injury.

High cervical spinal injury disrupts the sympathetic nervous system, leading to neurogenic shock. Losing sympathetic tone causes widespread vasodilation and pooling of blood, which produces hypotension. The heart’s accelerators are blunted, so bradycardia often accompanies the hypotension. Thermoregulation also falters because the hypothalamic control of heat loss and production relies on sympathetic pathways, making hypothermia common in the acute phase. Additionally, the injured autonomic axis can drive neurogenic pulmonary edema early, as fluid shifts and capillary leak develop in the lungs. Autonomic hyperreflexia is more typical later, after spinal shock has resolved, and fever with hypertension are not the hallmark features of the first 24 hours. So the combination of hypothermia, hypotension from neurogenic shock, and possible neurogenic pulmonary edema best fits the early period after a cervical spine injury.