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Article
June 1952

MANAGEMENT OF PAROXYSMAL HYPERTENSION FOLLOWING INJURIES TO CERVICAL AND UPPER THORACIC SEGMENTS OF THE SPINAL CORD

Author Affiliations

LOS ANGELES
From the Paraplegic and Neurosurgical Services of the Veterans Administration Hospital, Long Beach, and the Department of Surgery, University of California School of Medicine at Los Angeles.

AMA Arch Surg. 1952;64(6):803-812. doi:10.1001/archsurg.1952.01260010823012
Abstract

PATHOLOGIC autonomic reflex mechanisms which accompany injuries to the cervical and upper thoracic segments of the spinal cord have been observed and described and their clinical manifestations studied by means of physiologic investigations during the period following the first and second world wars.1 Many pathophysiologic phenomena were explained; yet no therapeutic effort was reported to eliminate permanently the most dangerous of these, namely, paroxysmal hypertension, which is caused by distention of hollow viscera and which threatens the life of the patient. The present study was stimulated by a previous observation2 on three cases in which pathologic autonomic reflexes became suppressed after the subarachnoid injection of absolute alcohol administered in order to abolish skeletal spasticity.3 Since subarachnoid alcohol block interrupts both afferent and efferent pathways below the level of injection, posterior rhizotomy at segments which supply the highly reflexogenic areas of the genitalia, bladder, and rectum would be

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