Which change occurs during neurogenic shock?

During neurogenic shock, the primary change that occurs is the loss of sympathetic control. This condition arises when there is a disruption in the autonomic nervous system, particularly the sympathetic pathways, usually due to spinal cord injury or neurological events. The sympathetic nervous system is responsible for the "fight or flight" response, which includes regulating heart rate and maintaining vascular tone. When this system is compromised, it leads to vasodilation and a decrease in peripheral vascular resistance, resulting in hypotension and reduced blood flow.

This loss of sympathetic control is crucial to recognizing how neurogenic shock differs from other types of shock, such as hypovolemic or cardiogenic shock, where compensatory mechanisms are still functioning to some extent. In neurogenic shock, the body's ability to respond to changes in blood pressure is severely impaired, leading to the classic signs of decreased heart rate and hypotension rather than the elevated heart rate and increased blood pressure seen in other forms of shock. Understanding this fundamental mechanism is essential for managing patients in neurogenic shock effectively.