neurogenic shock

-- The presence of shock in a pt with a head injury necessitates a search for another cause of shock. (Isolated intracranial injuries do not cause shock)

-- mechanism: loss of sympathetic tone
shock without tachycardia
shock without cutaneous vasoconstriction
shock without a narrowed pulse pressure

-- management: initially same as hypovolemia
Failure to restore organ perfusion with fluid resuscitation suggests
either continuing hemorrhage or neurogenic shock.
(CVP monitoring may be helpful in managing this sometimes complex problem.)