Neurogenic shock include on non-haemorrhagic shock. Neurogenic shock also called syncope. This shock happen because of abundant vasovagal reaction that lead to totally vasodilatation in sphlancnicus regio so that decrease cerebral vascularization. Vasovagal reaction is usually caused of hot environment temperature, fear, surprised, or pain. Neurogenic shock on trauma happen such as in spine injury, or the most seldom, brain stem injury.

Head injury that lead to shock condition can be caused by hemorrhagic and non-hemorrhagic shock.  Spine nerve injury can cause hypotension as the effect loss of capillary sympathetic tonus. Loss of capillary symphatetic tonus worsening hypovolemic effect and on the contrary, hypovolemic condition will worsen sympathetic denervation effect.

Classical finding on neurogenic shock is hypotension without present of tachycardia or skin vasoconstriction. The patient generally feel dizzy and then become unconscious. Decrease of pulse pressure is not found on neurogenic shock. After the patient lying down, usually go to spontaneous good condition without complicated remain, except if there is injury because of fall. The patient with spine injury often have injury in other body part. So that the patient is suspected or known have neurogenic shock, first time must be managed for hypovolemic.

Failure in curing organ perfusion with fluid rescucitation sign the bleeding still continue or in neurogenic shock condition. Evaluation central venous pressure may help for complicated problem. (doc b3ty)