A patient with speinal cord injury (SCI) and autonomic dysreflexia may be subject to headaches.


Patient selection: spinal cord injury with autonomic dysreflexia


Autonomic dysreflexia is associated with paroxysmal increase in the systolic blood pressure >= 30 mm Hg above baseline and/or in the diastolic blood pressure >= 20 mm Hg.


Features of headache associated with autonomic dysreflexia

(1) The patient has the onset of sudden headaches.

(2) The patient has been diagnosed with autonomic dysreflexia.

(3) Presence of 2 or more of the following:

(3a) The headache occurs with a temporal relation to a rise in blood pressure.

(3b) (The headache gets worse if the blood pressure increases.) OR (The headache improves with a decrease in blood pressure.)

(3c) The headaches have >= 2 of the following:

(3c1) intensity severe

(3c2) qualities as pounding, throbbing or pulsating

(3c3) triggered by bladder or bowel reflexes

(3c4) accompanied by diaphoresis cranial to the level of the spinal cord injury

(4) No other explanation can explain the headaches better.


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