Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + • Head injury• Increased intracranial pressure• Caused by pooling of blood in denervated autonomic venules and small veins• Usually due to spinal cord injury• Not caused by isolated head injury +++ Epidemiology + • Post-traumatic +++ Symptoms and Signs + • Hypotension after trauma• Warm extremities—sometimes with hyperemia• No other evident causes of shock, such as hypovolemic or cardiogenic + • Hypovolemic shock• Cardiogenic shock• Septic shock + • Therapeutic test: Trendelenburg followed by 2 L IV fluid bolus• If shock persists, consider phenylephrine infusion and other causes• Radiographic evaluation of spinal column + • Supportive care of blood pressure to maintain perfusion• Stabilize and protect spine from further injury +++ References ++Kress JP et al: Daily interruption of sedative infusions in critically ill patients undergoing mechanical ventilation. N Engl J Med 2000;342:1471. [PubMed: 10816184] ++MacIntyre NR et al: Evidence-based guidelines for weaning and discontinuing ventilatory support: a collective task force facilitated by the American College of Chest Physicians; the American Association for Respiratory Care; and the American College of Critical Care Medicine. Chest 2001;120(6 Suppl):375S. Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.