Impact of treatment for neurogenic bladder dysfunction on autonomic dysreflexia and cerebral blood flow in SCI individuals
Spinal cord injury (SCI) resulting from traumatic accidents is one of the most debilitating chronic conditions. In addition to the toll on quality of life, lifetime health care expenditures for these patients are among the most expensive of any medical condition, since many injuries occur in young patients who live with SCI for decades. SCI also comes with steep indirect costs, including morbidity due to chronic complications.
In individuals with SCI, bladder dysfunction and episodes of high blood pressure are two chronic conditions that present as significant clinical problems. Bladder dysfunction is commonly associated with a sudden, life threatening increase in blood pressure known as autonomic dysreflexia (AD). This episodic hypertension cannot be addressed with typical treatments, and if misdiagnosed or poorly managed can lead to myocardial infarction, stroke, and even death. Bladder dysfunctions and irritation such as a urinary tract infection are leading triggers for AD.
It is suspected that chronic exposure to AD episodes results in cerebrovascular damage in those with SCI. Chronically elevated blood pressure negatively impacts the brain and is specifically associated with cerebrovascular decline, altered brain morphology, cognitive dysfunctions and stroke in able-bodied individuals. However, identical pathologies are present in those with SCI.
Dr. Walter will investigate whether treating bladder dysfunction in patients with SCI will decrease possible triggers for episodes of AD, ameliorate its symptoms and consequently reduce chronic cardiovascular complications. Reducing the chronic cardio- and cerebrovascular complications of SCI would dramatically improve the health and wellbeing of patients with SCI and positively impact health care costs.