What You Should Know About Neurogenic Shock

Medically Reviewed by Christopher Melinosky, MD on August 16, 2023
3 min read

The phrase "going into shock" is a common line in medical dramas, but the actors don't always explain what that means. Shock is a sudden drop in blood flow in your body, and it comes with serious health risks. Your organs may not get enough blood while you are in shock, and that can cause permanent organ damage.

There are four types of shock:

  • Hypovolemic shock: Shock due to blood loss
  • Distributive shock: Shock due to an imbalanced internal fluid volume
  • Cardiogenic shock: Shock due to the heart not working properly
  • Obstructive shock: Shock due to a blockage of a major blood vessel or the heart

Neurogenic shock is a subtype of distributive shock. It is often a side effect of a spine injury. While any type of shock needs swift medical attention, neurogenic shock should be treated as quickly as possible. Spine injuries are very serious and need to be treated right away.

Neurogenic shock occurs when blood vessels stop working properly and don't push enough blood through the body. You don't experience blood loss, but the blood doesn't circulate correctly. The blood pools in your blood vessels, and your blood pressure drops significantly.

The cause of neurogenic shock is usually a spinal cord injury. When the nerves in the spinal cord are damaged, they stop sending messages to the nerves that control other functions in the body. If nerve signals to the muscles in the blood vessels are shut down, the vessels stop working properly.

A stroke or blood clot that prevents blood from circulating can also bring on neurogenic shock. In rare cases, people have neurogenic shock in reaction to spinal anesthesia. It can also be a side effect of some medications or a brain infection, such as meningitis.

Neurogenic shock is a life-threatening condition that requires immediate medical attention. The symptoms of neurogenic shock are all evidence that blood flow in the body is diminished, including:

Low blood pressure (hypotension). If you are experiencing neurogenic shock, your blood pressure will drop. Your blood is not circulating the way it usually would due to the loss of muscle activity in your blood vessels. This puts you at risk of organ damage. Without blood carrying oxygen through your body, organs can become oxygen-starved, and the tissue dies.

Lowheart rate (bradycardia). In addition, you will experience bradycardia. This refers to a slower than normal heart rate. A typical heart rate is 60 to 100 beats per minute. During an episode of bradycardia, the heart rate slows to under 60 beats per minute. This exacerbates the lack of blood flow in the body.

Body temperature changes. Lack of blood flow can affect your body's ability to regulate temperature. Your body temperature may drop or rise and fall rapidly.

Flushed skin. Because your blood is pooling in your veins instead of moving around, your skin may start to look flushed. The skin will feel warm and dry to the touch due to blood volume under the skin. This may be the case even if your core temperature is lower than average.

If a spine injury causes neurogenic shock, stabilizing the spine is often the first step in treatment. Managing any other injuries will also be a top priority in this situation. You may need to be immobilized to stabilize the injury. Medical staff will also take steps to make sure that you can breathe properly. In extreme situations, this may require intubation and a machine to help with breathing.

Once medical staff has managed a spine injury, they will work to get your blood pressure back to normal. IV fluids are one method they will use. Doctors will also use the IV to deliver medicine that can stimulate your blood vessels and heart to work properly. They may also give you other medications as needed to manage other symptoms.

How well you recover from neurogenic shock depends on whether you have significant organ damage from the lack of blood flow during shock. If you have a spinal injury, the recovery from the injury itself will also be a factor. Your doctors will talk to you about your prognosis. They will help you set up a recovery plan that is appropriate for your injuries.

If you suspect you or someone else is experiencing neurogenic shock, call for emergency assistance immediately.