Which sign is typically observed above the level of spinal injury during autonomic dysreflexia?

• A. Flushed face
• B. Pale skin
• C. Cold hands
• D. Decreased sweating

Answer: (A)

Autonomic dysreflexia occurs with high-level spinal cord injuries (often at or above T6). A noxious stimulus below the lesion triggers a massive sympathetic response that causes vasoconstriction below the level of injury, leading to a dangerous rise in blood pressure. The brain cannot regulate below the injury, but it can send a parasympathetic signal above the level, causing vasodilation in areas above the injury. This results in the face becoming flushed and red, which is the sign observed above the level of injury. Below the level, vasoconstriction produces pale, cool skin and reduced sweating. So facial flushing is the typical sign above the level during autonomic dysreflexia.