Incidence of Neurogenic Shock

Neurologically injured patients, regardless of the nature of the injury, frequently experience hypotension and shock. Neurogenic shock refers to a neurologically mediated form of circulatory system failure that can occur with acute brain, spinal cord, or even peripheral nerve injuries. In this chapter, we will explain the epidemiology, pathophysiology, clinical presentation, and management strategies for this special form of shock. Contrary to common belief, neurogenic shock is not a single entity due to one single pathologic mechanism. The term is sometimes used in nonneuroscience intensive care units to explain hypotension occurring in any brain-injured patient, but neurogenic shock should be considered only after systemic causes of shock have been carefully ruled out. Just like other critically ill patients, neurologically ill patients are prone to developing systemic conditions, such as dehydration, congestive heart failure, acute blood loss, sepsis, pericardial tamponade, or massive pulmonary embolism.