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OTHER COMPLICATIONS OF SPINAL CORD INJURY: POSTURAL (ORTHOSTATIC) HYPOTENSION

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     Postural hypotension, also known as orthostatic hypotension, is a condition which results in a decrease in blood pressure when you sit or stand. This can cause "light-headedness" or "fainting". It occurs more commonly when you are first injured, when you are fatigued, or after any illness. You will have an increased tendency for postural hypotension if your level of injury is at T-6 or above, but it can occur in all spinal cord injured individuals.

     After your spinal cord injury, the blood vessels do not decrease in size, in response to lowered blood pressure, due to the altered function of the autonomic nervous system. Because of this, blood pools in the pelvic region or legs while you are sitting or sanding.

     Postural hypotension usually occurs when you are initially placed in your wheelchair or on the tilt table. To prevent this, wear elastic hose and an abdominal support. It is also helpful to come to a sitting or standing position gradually.

     If postural hypotension occurs while you are in a wheelchair, your attendant should firmly grab the handles of the wheelchair and tilt you backward, until your head and neck are nearly horizontal to the floor. This will increase your blood pressure and the "fainting" will quickly disappear. You should then be gradually returned to a sitting position.

     Another problem that may occur as a result of the lowered blood pressure is a decrease in the amount of urine produced by the kidneys. You may notice that there is little or no urine in your urine bag. After you recline, your leg bag may fill quickly. This is a result of the increase in your blood pressure that occurs when you lie down. Watch your drainage bag closely after changing positions to make sure it does not get too full.

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