Complications

Discussion

Two studies reported the complications that may result from bouts of AD in individuals with SCI (Wan & Krassioukov 2014; Dolinak & Balraj 2007). In a systematic review of clinical studies, Wan and Krassioukov (2014) found CNS-related, CV, and pulmonary complications following episodes of AD. CNS-related complications were most commonly hemorrhage, but cerebral ischemia/ infarction and seizures or convulsions were also present (Wan & Krassioukov 2014). CV complications included cardiac arrest, arrhythmia, and silent myocardial ischemia; while pulmonary complications identified were pulmonary edemas (Wan & Krassioukov 2014). A case study by Dolinak and Balraj (2007) found that episodes of AD in a 62-year-old male were accompanied by abrupt and intense headaches, abnormal mental status, and resulted in a severe subarachnoid hemorrhage and death, despite treatment with nitroglycerin paste.

Conclusion

There is level 1 evidence (from one systematic review) (Wan & Krassioukov 2014) that cases of AD may result in CNS-related, CV, and pulmonary complications, including those resulting in death.

There is level 5 evidence (from one case report) (Dolinak & Balraj 2007) that AD episodes were accompanied by headaches, followed by abnormal mental status, resulting in a severe subarachnoid hemorrhage and death.