Cushing's syndrome is due to long-term glucocorticoid excess that may have various etiologies. Its pathogenesis can be divided into adrenocorticotropic hormone (ACTH) dependent (from a pituitary or ectopic source) and ACTH independent (). 1 The most common form is pituitary-dependent bilateral adrenal hyperplasia, which is termed Cushing's disease. Sep 1, 2000 · Cushing's disease is responsible for roughly two thirds of the cases of endogenous Cushing's syndrome. 1, 3, 4 The remainder of the endogenous cases are caused by ectopic ACTH-secreting tumors and ... The primary symptoms of Cushing’s syndrome in children who are still growing is a dramatic slowing in vertical growth, while the child continues to gain weight. Weight gain, specifically in the mid-torso. Vertical growth slows or stops. Thin arms and legs compared to the rest of the body. Stretch marks on abdomen, arms, thighs and buttocks. Cushing syndrome may be the result of using corticosteroid medications for a long time. Corticosteroids may be prescribed to manage asthma, arthritis, and other diseases. High Cortisol Levels Symptoms and Signs. There are several symptoms and signs of Cushing’s syndrome which include: Symptoms. Fatigue; Mid-section weight gain; Bruising easilyApr 24, 2022 · Cushing's syndrome is a risk of taking steroid medications for a long time. It's important to work closely with your medical team and report any side effects you may be experiencing. Cushing's syndrome can be treated by lowering the number of steroids being taken, and by treating some of the signs and symptoms. May 20, 2022 · Symptoms of Cushing's Disease in Horses. Cushing’s disease is a progressive disorder. The symptoms may be slow to present but will ultimately progress with time. The most common signs observed in horses with Cushing’s disease/PPID include: Failure to shed winter coat fully, or patchy shedding; Long and/or curly coat; Chronic infections The Most Common Symptoms of Cushing Syndrome Are: Cushing Syndrome causes many symptoms throughout the body. Weight gain with central obesity (meaning unusual fat deposition around your abdomen) Facial rounding and plethora (called moon face) Supraclavicular and dorsocervical fat pads (fat deposits on the back; “buffalo hump”) Easy bruising ...Jun 29, 2015 · Aggression, increased pursuance of food and water, exercise intolerance, lethargy, and difficulty moving around in their day-to-day environments (navigating stairs, going up onto elevated surfaces, etc.) are some of the behavior changes commonly seen in dogs afflicted by Cushing’s disease. Image: Ljiljana Jankovic / Shutterstock. Oct 29, 2020 · Additionally, 15-20% of dogs with pituitary tumors develop neurologic signs as the tumor grows and 5-10% of Cushing’s patients will also develop diabetes. Although rare, Cushing’s patients are also at risk for fatal blood clots called pulmonary thromboembolisms . It is then compressed at constant pressure to its original state. All the steps are quasi-static and reversible. (a) (a) Show this cycle on a P V P V diagram. For each step of the cycle, find the work done by the gas, the heat absorbed by the gas, and the change in the internal energy of the gas. Verified answer.Cushing's disease is a metabolic disorder caused by long-term exposure to an excess of the hormone cortisol in the body ( stress hormone). This disorder is caused by an excess of adrenocorticotropic hormone released by the pituitary gland. Cushing’s disease is an uncommon variant of Cushing’s syndrome.Aggression, increased pursuance of food and water, exercise intolerance, lethargy, and difficulty moving around in their day-to-day environments (navigating stairs, going up onto elevated surfaces, etc.) are some of the behavior changes commonly seen in dogs afflicted by Cushing’s disease. Image: Ljiljana Jankovic / Shutterstock.Iatrogenic Cushing's this condition is caused by an irresponsible and excess use of synthetic cortisol versions. Signs of Cushing's Disease in Dogs Dogs suffering from Cushing's disease will show one or more of the following signs and symptoms: Increased appetite; Increased thirst and frequent urination; Enlarged abdomen with a potbellied ...Apr 20, 2020 · What is the prognosis for an animal diagnosed with Cushing’s disease? The prognosis for pituitary dependent Cushing’s disease with treatment is usually good. Some signs will disappear quickly and others gradually. Appetite and water consumption usually return to normal in a few weeks, but full return of fur lost may take several months. Cushing's syndrome is a collection of signs and symptoms due to prolonged exposure to glucocorticoids such as cortisol. Signs and symptoms may include high blood pressure, abdominal obesity but with thin arms and legs, reddish stretch marks, a round red face due to facial plethora, a fat lump between the shoulders, weak muscles, weak bones, acne, and fragile skin that heals poorly. The spectrum of Cushing syndrome. Symptoms caused by excess cortisol, including high blood pressure, obesity, and difficulty controlling blood sugar, may also be common in the general population. As a result, Cushing syndrome may be challenging to diagnose. Although Cushing syndrome may look different and have many different symptoms, one ...The symptoms of Cushing's disease are similar to those seen in other causes of Cushing's syndrome. Patients with Cushing's disease usually present with one or more signs and symptoms secondary to the presence of excess cortisol or ACTH. Although uncommon, some patients with Cushing's disease have large pituitary tumors (macroadenomas). The symptoms of Cushing's disease are similar to those seen in other causes of Cushing's syndrome. Patients with Cushing's disease usually present with one or more signs and symptoms secondary to the presence of excess cortisol or ACTH. Although uncommon, some patients with Cushing's disease have large pituitary tumors (macroadenomas). Apr 20, 2020 · What is the prognosis for an animal diagnosed with Cushing’s disease? The prognosis for pituitary dependent Cushing’s disease with treatment is usually good. Some signs will disappear quickly and others gradually. Appetite and water consumption usually return to normal in a few weeks, but full return of fur lost may take several months. Apr 24, 2022 · Cushing's syndrome is a risk of taking steroid medications for a long time. It's important to work closely with your medical team and report any side effects you may be experiencing. Cushing's syndrome can be treated by lowering the number of steroids being taken, and by treating some of the signs and symptoms. Depression, Anxiety, Irritability. Depression, anxiety, and irritability are common symptoms of everyday stress. Similarly, when cortisol is constantly in production even without the presence of stress, the individual will feel much the same. One of the extra dangers of Cushing’s disease is that it may lead to psychological issues, such as ...Equine Cushing’s disease is one of the most common diseases of horses greater than 15 years of age. The clinical signs are associated with abnormally elevated hormone concentrations in the blood and along with other hormones, cortisol, plays an important role in this disease. This syndrome is better defined as Equine Pituitary Pars Intermedia ...Jun 26, 2023 · Introduction. Cushing syndrome is caused by prolonged exposure to high circulating levels of cortisol. The most common cause of cushingoid features is iatrogenic corticosteroid use, while some herbal preparations can also increase circulating corticosteroid levels leading to Cushing syndrome. Cushing syndrome can be interchangeably called ... Oct 17, 2011 · 3. Watch closely for signs such as lack of appetite that may indicate drugs need to be stopped or dosage adjusted. 4. lf your dog has all the signs of Cushing’s but tests are negative, consider atypical Cushing’s or adrenal exhaustion as a possible cause. Sometimes life-threatening illnesses develop so slowly that no one pays much attention. Any collection of signs and symptoms should be evaluated by a medical doctor as soon as possible. Left untreated, signs of Cushing’s syndrome can lead to further complications and worsening of symptoms – increased fatigue, weakening of muscles, bones and the spine, as well as a suppressed immune system, to name a few. Excerpt. The Cushing reflex (vasopressor response, Cushing reaction, Cushing effect, and Cushing phenomenon) is a physiological nervous system response to acute elevations of intracranial pressure (ICP), resulting in Cushing’s triad of widened pulse pressure (increasing systolic, decreasing diastolic), bradycardia, and irregular respirations.Cushing’s disease is a chronic condition that necessitates long term care and monitoring tests. Familiarity with the symptoms enables dog parents to recognize the early warning signs and seek prompt treatment. With appropriate care, dogs with Cushing’s disease can lead long and happy lives.A Combination of all listed Cushing’s Symptoms in Dogs: If a dog exhibits multiple major warning signs of Cushing’s, there is a very high chance that the dog has Canine Cushings Disease. Increased Cortisol Levels: The most reliable indicator of Cushing’s in dogs symptoms is increased cortisol levels. This is the most direct analysis and ... Symptoms of Cushing’s Disease in Dogs. Cushing’s Disease causes an excess of cortisol, the stress hormone. Too much cortisol causes changes within the skin, so it becomes paper thin with blackheads (comedones) and no fur. It also causes excessive panting, excessive thirst, and a ravenous appetite. You might notice that your dog has become a ...A Combination of all listed Cushing’s Symptoms in Dogs: If a dog exhibits multiple major warning signs of Cushing’s, there is a very high chance that the dog has Canine Cushings Disease. Increased Cortisol Levels: The most reliable indicator of Cushing’s in dogs symptoms is increased cortisol levels. This is the most direct analysis and ... Sep 10, 2021 · Iatrogenic Cushing's this condition is caused by an irresponsible and excess use of synthetic cortisol versions. Signs of Cushing's Disease in Dogs Dogs suffering from Cushing's disease will show one or more of the following signs and symptoms: Increased appetite; Increased thirst and frequent urination; Enlarged abdomen with a potbellied ... The most common signs seen with hyperadrenocorticism include excessive urination, excessive drinking, increased appetite, hair loss, muscle weakness, a “potbellied” appearance, panting, thin skin and lethargy. Virtually all dogs with Cushing’s disease have at least one of these signs, but it would be uncommon to have all of them.Cushing’s triad, consisting of bradycardia, irregular respirations, and widened pulse pressures, is the body ’s response to increased intracranial pressure (ICP). It usually indicates a severe lack of oxygen in the brain tissue. The Cushing reflex and subsequent triad are the body ’s final attempts to oxygenate the brain and prevent ...Dogs with Cushing’s disease will have varying symptoms depending on how far progressed through the disease timeline they are. The first symptoms can be subtle: lethargy, panting, and increased thirst. Let’s now review the signs and symptoms in the advanced stages of the disease.Oct 1, 1998 · The signs associated with Cushing’s syndrome are extremely varied and differ in severity . Signs that differentiate Cushing’s syndrome from pseudo-Cushingoid states most reliably include the presence of proximal myopathy, easy bruising, and thinness and fragility of the skin (36, 37). In our experience signs such as buffalo hump, obesity ... 10 Telltale Signs of Cushing’s Disease. Trouble shedding winter coat. Hair may become long, matted and curly. Lots of drinking and urination. Increased sweating. Heightened appetite. Potbelly appearance. Fat deposits above the eyes, crest of neck and tail head. Poor topline.Apr 24, 2022 · Cushing's syndrome is a risk of taking steroid medications for a long time. It's important to work closely with your medical team and report any side effects you may be experiencing. Cushing's syndrome can be treated by lowering the number of steroids being taken, and by treating some of the signs and symptoms. The symptoms of Cushing's disease are similar to those seen in other causes of Cushing's syndrome. Patients with Cushing's disease usually present with one or more signs and symptoms secondary to the presence of excess cortisol or ACTH. Although uncommon, some patients with Cushing's disease have large pituitary tumors (macroadenomas). These are the most common signs and symptoms: Upper body obesity with thin arms and legs Round face Increased fat around neck or a fatty hump between the shoulders Reddened, thin, fragile skin that is slow to heal Reddish-blue stretch marks on the underarms, belly, thighs, buttocks, arms, and breasts Bone and muscle weaknessSep 10, 2021 · Iatrogenic Cushing's this condition is caused by an irresponsible and excess use of synthetic cortisol versions. Signs of Cushing's Disease in Dogs Dogs suffering from Cushing's disease will show one or more of the following signs and symptoms: Increased appetite; Increased thirst and frequent urination; Enlarged abdomen with a potbellied ... A tumor of one or both adrenal glands, resulting in excess cortisol production. Benign (adenomas): 50%. Malignant (carcinomas): 50%. Possibility of spreading to other organs (14-50% of cases) A third form results from administering cortisol as a medication, and this type is known as Iatrogenic Cushing’s syndrome. Cushing's syndrome is due to long-term glucocorticoid excess that may have various etiologies. Its pathogenesis can be divided into adrenocorticotropic hormone (ACTH) dependent (from a pituitary or ectopic source) and ACTH independent (). 1 The most common form is pituitary-dependent bilateral adrenal hyperplasia, which is termed Cushing's disease. Nov 9, 2021 · Dogs with a urine specific gravity greater than 1.025 are less likely to have Cushing’s. This is by far the most accurate, safe and effective method of diagnosing Cushing’s disease. If this test shows an elevated Cortisol-Creatinine ratio, you’ll also want to follow up with an ultrasound. I’ll talk about this next. Apr 24, 2022 · Cushing's syndrome is a risk of taking steroid medications for a long time. It's important to work closely with your medical team and report any side effects you may be experiencing. Cushing's syndrome can be treated by lowering the number of steroids being taken, and by treating some of the signs and symptoms. 2. Treatment for Cushing’s can improve quality of life for your dog. Don’t be afraid to try drugs when needed. 3. Watch closely for signs such as lack of appetite that may indicate drugs need to be stopped or dosage adjusted. 4. lf your dog has all the signs of Cushing’s but tests are negative, consider atypical Cushing’s or adrenal ...Cushing's disease typically occurs in middle-aged to older dogs. The disease develops slowly and the early signs are not always noticed. Symptoms in dogs include. increased thirst; Jan 11, 2017 · Cushing’s disease is a chronic condition that necessitates long term care and monitoring tests. Familiarity with the symptoms enables dog parents to recognize the early warning signs and seek prompt treatment. With appropriate care, dogs with Cushing’s disease can lead long and happy lives. Any collection of signs and symptoms should be evaluated by a medical doctor as soon as possible. Left untreated, signs of Cushing’s syndrome can lead to further complications and worsening of symptoms – increased fatigue, weakening of muscles, bones and the spine, as well as a suppressed immune system, to name a few. Aug 10, 2017 · The most common signs seen with hyperadrenocorticism include excessive urination, excessive drinking, increased appetite, hair loss, muscle weakness, a “potbellied” appearance, panting, thin skin and lethargy. Virtually all dogs with Cushing’s disease have at least one of these signs, but it would be uncommon to have all of them. Jan 22, 2018 · Signs of PPID include: Unusual hair coat. Horses with PPID will have changes in their coats, though these variations do not follow a prescribed pattern. Some horses might have delayed shedding of their winter coat, or fail to shed a winter coat entirely, while others may grow an unusually dense, patchy, wavy, or curly coat. Hoof problems. Cushing’s syndrome (CS) is a rare problem caused when the adrenal gland (s) makes too much of a hormone called cortisol. CS is most often due to a tumor or mass found in the pituitary gland, but can also be caused by tumors in the adrenal glands themselves. People with Cushing's syndrome may see their face get round ("moon face"), they gain ...What Are the Cushing’s Signs and Symptoms? The biggest impact of the chronic overproduction of stress hormones is on the immune system of your dog, which weakens. This can make the pet more vulnerable to other ailments and infections. It can even harm a few vital organs, compromising the pet’s overall health.In many equine Cushing’s cases, a veterinarian can make a diagnosis based on clinical signs alone. A shaggy hair coat that doesn’t shed is considered a hallmark sign of this disease, making many cases relatively easy to identify. However, if clinical signs are mild or unclear, diagnostics should be conducted.Cushing's syndrome is a risk of taking steroid medications for a long time. It's important to work closely with your medical team and report any side effects you may be experiencing. Cushing's syndrome can be treated by lowering the number of steroids being taken, and by treating some of the signs and symptoms.Jun 26, 2023 · According to Contreras, this is the order in which you may commonly notice Cushing’s symptoms in your dog: Stage 1. Signs of Cushing’s during this stage are modest. Your dog may start drinking ... Treatment is typically pursued when the clinical signs start affecting a dog’s quality of life, and also when it’s necessary to reduce the complications associated with Cushing’s syndrome. It’s important to talk with your veterinarian about how to weigh the risks of surgery or the possible side effects of available medications.One of the first signs of Cushing syndrome, is the loss of this diurnal variation. Although it has been shown that detecting increased midnight serum cortisol level has high sensitivity for patients with Cushing syndrome, obtaining a stress-free late-night blood sample in routine outpatient clinical practice is not always feasible.Cushing disease is hyperadrenocorticism caused by an ACTH-secreting tumor of the pituitary gland. Clinical signs include polyuria, polydipsia, alopecia, and muscle weakness. A low-dose dexamethasone suppression test is the preferred diagnostic test. Treatment options include medical therapy, radiation, and surgery. Any collection of signs and symptoms should be evaluated by a medical doctor as soon as possible. Left untreated, signs of Cushing’s syndrome can lead to further complications and worsening of symptoms – increased fatigue, weakening of muscles, bones and the spine, as well as a suppressed immune system, to name a few. The patient contracts his/her arms and curls them toward the chest. Pain when attempting to straighten the knee with the hips flexed. You are assessing a middle-aged unconscious man who is lying in bed. His skin is cool and clammy. His heart rate is 124 beats/min, his respiratory rate is 140 breaths/min, and his blood pressure level is 74/52 mm Hg.Cushing syndrome, also called hypercortisolism, is a set of symptoms resulting from exposure to high levels of the stress hormone cortisol. Cortisol, a hormone in the body that is typically produced in response to stress, helps regulate blood pressure and blood sugar, reduce inflammation, and metabolize food. Cortisol production and release is ...Cushing disease is hyperadrenocorticism caused by an ACTH-secreting tumor of the pituitary gland. Clinical signs include polyuria, polydipsia, alopecia, and muscle weakness. A low-dose dexamethasone suppression test is the preferred diagnostic test. Treatment options include medical therapy, radiation, and surgery.Overview What is Cushing syndrome? Cushing syndrome is an uncommon condition that happens when your body has too much of a hormone called cortisol. Another word for Cushing syndrome is hypercortisolism. A syndrome is a medical term that refers to a group of signs and symptoms that happen together.Cushing’s syndrome is a hormonal condition that occurs when a person’s cortisol levels are too high. It can have severe and wide-ranging effects on the body. It often results from using ...Obesity, diabetes, high blood pressure, depression, and many of the other signs on the list can all contribute to erectile dysfunction. Add that to the hormone disruption caused by Cushing’s in the first place, and it’s a recipe for erectile dysfunction. 15. Difficulty getting pregnant.According to Bruyette, dogs in which meal- or food-induced hyperadrenocorticism is diagnosed are young, with an early onset of clinical signs between 2 and 5 years of age. Bruyette and other clinicians have found no breed predilection, but so far he says all of the cases have been in small dogs. “These are dogs that look floridly Cushingoid ...What is the prognosis for an animal diagnosed with Cushing’s disease? The prognosis for pituitary dependent Cushing’s disease with treatment is usually good. Some signs will disappear quickly and others gradually. Appetite and water consumption usually return to normal in a few weeks, but full return of fur lost may take several months.A tumor of one or both adrenal glands, resulting in excess cortisol production. Benign (adenomas): 50%. Malignant (carcinomas): 50%. Possibility of spreading to other organs (14-50% of cases) A third form results from administering cortisol as a medication, and this type is known as Iatrogenic Cushing’s syndrome. The most common signs seen with hyperadrenocorticism include excessive urination, excessive drinking, increased appetite, hair loss, muscle weakness, a “potbellied” appearance, panting, thin skin and lethargy. Virtually all dogs with Cushing’s disease have at least one of these signs, but it would be uncommon to have all of them.Symptoms of Cushing’s Disease in Dogs. Cushing’s Disease causes an excess of cortisol, the stress hormone. Too much cortisol causes changes within the skin, so it becomes paper thin with blackheads (comedones) and no fur. It also causes excessive panting, excessive thirst, and a ravenous appetite. You might notice that your dog has become a ...Although Cushing’s can’t be cured, administration of this medication can help control symptoms, and possibly slow the progression of the disease. If your horse is showing a lot of clinical signs of Cushing’s disease, your vet may even recommend initiating treatment before the ACTH or LDD tests come back positive.Depression, Anxiety, Irritability. Depression, anxiety, and irritability are common symptoms of everyday stress. Similarly, when cortisol is constantly in production even without the presence of stress, the individual will feel much the same. One of the extra dangers of Cushing’s disease is that it may lead to psychological issues, such as ...Treatment is typically pursued when the clinical signs start affecting a dog’s quality of life, and also when it’s necessary to reduce the complications associated with Cushing’s syndrome. It’s important to talk with your veterinarian about how to weigh the risks of surgery or the possible side effects of available medications.Cushing syndrome is a constellation of clinical abnormalities caused by chronic high blood levels of cortisol or related corticosteroids. Cushing disease is Cushing syndrome that results from excess pituitary production of adrenocorticotropic hormone (ACTH), generally secondary to a pituitary adenoma. Typical symptoms and signs include moon ...Jun 26, 2023 · Introduction. Cushing syndrome is caused by prolonged exposure to high circulating levels of cortisol. The most common cause of cushingoid features is iatrogenic corticosteroid use, while some herbal preparations can also increase circulating corticosteroid levels leading to Cushing syndrome. Cushing syndrome can be interchangeably called ... What Are the Cushing’s Signs and Symptoms? The biggest impact of the chronic overproduction of stress hormones is on the immune system of your dog, which weakens. This can make the pet more vulnerable to other ailments and infections. It can even harm a few vital organs, compromising the pet’s overall health. May 22, 2019 · When the hormones in the body are out of balance, bad things start happening. “The most striking symptom in Cushing’s disease is excessive urination and concurrently drinking tremendous ...
Apr 29, 2019 · Signs that it’s time for treatment include: High blood pressure. Excessive panting. Bladder control issues. Reluctance to exercise. Infections. When treating pituitary gland Cushing’s disease, vets usually prescribe a drug called Trilostane. This drug does not play well with other medication. . Greypercent27s anatomy imdb
Any collection of signs and symptoms should be evaluated by a medical doctor as soon as possible. Left untreated, signs of Cushing’s syndrome can lead to further complications and worsening of symptoms – increased fatigue, weakening of muscles, bones and the spine, as well as a suppressed immune system, to name a few.Sep 10, 2021 · Iatrogenic Cushing's this condition is caused by an irresponsible and excess use of synthetic cortisol versions. Signs of Cushing's Disease in Dogs Dogs suffering from Cushing's disease will show one or more of the following signs and symptoms: Increased appetite; Increased thirst and frequent urination; Enlarged abdomen with a potbellied ... The most common signs of Cushing’s disease are often increased thirst and hunger, but there are many others, including: Hair loss. Excessive panting. Lethargy. Increased appetite, thirst, and urination. Urinary tract infections. Bacterial skin infections. Hard skin on the nose and paw pads.When the hormones in the body are out of balance, bad things start happening. “The most striking symptom in Cushing’s disease is excessive urination and concurrently drinking tremendous ...The symptoms and signs of Cushing's syndrome can include: a rounded face. weight around the torso, shoulders and neck, but thin arms and legs. a hump between the shoulders. high blood sugar or diabetes. high blood pressure. feeling tired or emotional. skin problems like slow healing of wounds, bruising and stretch marks on the tummy, hips and ... One of the more distinctive signs of Cushing’s disease in dogs as the condition progresses is a pot-bellied appearance, which results from enlargement of the liver and a redistribution of body fat. Hair loss is also common, especially on the abdomen. Common symptoms of Cushing’s disease: Excessive panting. LethargyEquine Cushing’s disease is one of the most common diseases of horses greater than 15 years of age. The clinical signs are associated with abnormally elevated hormone concentrations in the blood and along with other hormones, cortisol, plays an important role in this disease. This syndrome is better defined as Equine Pituitary Pars Intermedia ...The spectrum of Cushing syndrome. Symptoms caused by excess cortisol, including high blood pressure, obesity, and difficulty controlling blood sugar, may also be common in the general population. As a result, Cushing syndrome may be challenging to diagnose. Although Cushing syndrome may look different and have many different symptoms, one ...Mar 2, 2022 · Adrenal Dependent Cushing’s. This type of Cushing’s usually signifies there is a tumor on the adrenal gland. If your dog has an adrenal tumor growing on the adrenal glands, your vet may suggest abdominal surgery to remove it. Adrenal tumors as a cause of the disease is rare and affects only about 10% of the dogs treated for the disease. While Cushing’s is relatively rare, the signs and symptoms are common to many other diseases. For instance, females with excess hair growth, irregular or absent periods, decreased fertility, and high glucose levels could have polycystic ovarian syndrome, a disease that affects many more women than Cushing’s. What are the clinical signs of Cushing’s disease? Regardless of the type, the clinical signs of Cushing’s disease are essentially the same. The most common clinical signs are an increase in appetite, increase water consumption, and urinating more. The increased appetite is a direct result of elevated levels of cortisol, which stimulate ... Jul 31, 2023 · Cushing triad is a clinical syndrome consisting of hypertension, bradycardia, and irregular respiration and is a sign of impending brain herniation. This occurs when the ICP is too high the elevation of blood pressure is a reflex mechanism to maintain CPP. High blood pressure causes reflex bradycardia and brain stem compromise affecting ... .