Which injury is most commonly associated with neurogenic shock?

Neurogenic shock is primarily caused by an injury to the central nervous system that disrupts autonomic nervous system pathways, leading to loss of sympathetic tone. In this context, cervical spine injuries are most commonly associated with neurogenic shock due to the impact on the sympathetic nervous system's control over vascular tone and heart rate.

When a cervical spine injury occurs, particularly at the levels that affect the thoracic outlet, it can result in the inability to regulate blood vessel constriction. This leads to widespread vasodilation, which can drastically decrease systemic vascular resistance and cardiac output, resulting in hypotension and bradycardia characteristic of neurogenic shock. As such, a cervical spine injury is a key injury associated with this condition and is often the most relevant and critical for consideration in the context of neurogenic shock during PALS assessments.

Other types of injuries listed, such as head injuries, pelvic fractures, and abdominal trauma, may be associated with various shock states, such as hypovolemic or septic shock, but they do not specifically disrupt the autonomic pathways in the same manner as a cervical spine injury, making them less directly related to neurogenic shock.