Document Detail


Paraplegia after spontaneous dissection of the abdominal aorta.
MedLine Citation:
PMID:  19736638     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We report a case with spinal cord ischemia and consecutive paraplegia following spontaneous isolated abdominal aortic dissection (IAAD). A 63-year-old female was admitted to the surgical emergency room with severe lumbar back pain and accompanying paresthesia of both legs. Contrast enhanced computed tomograpy (CT) of the abdomen showed an infrarenal IAAD in a normal size aorta with patent lumbar arteries. It was assumed that a surgical or interventional approach would not be helpful to improve spinal cord perfusion. Therefore, non operative therapy consisted of lowering blood pressure to prevent further dissection. The patient developed an anterior spinal artery syndrome with permanent paraplegia. Thus, blood pressure was raised for optimal spinal cord perfusion. To lower the spinal pressure, cerebrospinal fluid drainage was attempted. A three month follow-up CT scan showed spontaneous remodelling of the aorta. The neurological deficit persisted. IAAD is a rare differential diagnosis of lumbar back pain and can be associated with paraplegia as the leading symptom. Individualized treatment is indicated. Surgical treatment options concerning paraplegia are limited.
Authors:
P H??lper; A Hyhlik-D??rr; D Kotelis; H von Tengg-Kobligk; D B??ckler
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  VASA. Zeitschrift f??r Gef??sskrankheiten. Journal for vascular diseases     Volume:  38     ISSN:  0301-1526     ISO Abbreviation:  VASA     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-09-08     Completed Date:  2009-10-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0317051     Medline TA:  Vasa     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  254-8     Citation Subset:  IM    
Affiliation:
Klinik f??r Gef??sschirurgie, Universit??t Heidelberg, Germany. Peter.Hoelper@med.uni-heidelberg
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MeSH Terms
Descriptor/Qualifier:
Adrenal Cortex Hormones / therapeutic use
Aneurysm, Dissecting / complications*,  diagnosis,  physiopathology,  therapy
Aortic Aneurysm, Abdominal / complications*,  diagnosis,  physiopathology,  therapy
Aortography / methods
Blood Pressure
Diuretics / therapeutic use
Female
Humans
Low Back Pain / etiology
Magnetic Resonance Imaging
Middle Aged
Neurologic Examination
Paraplegia / diagnosis,  etiology*,  physiopathology,  therapy
Paresthesia / etiology
Regional Blood Flow
Spinal Cord Ischemia / diagnosis,  etiology*,  physiopathology,  therapy
Spinal Puncture
Tomography, X-Ray Computed
Treatment Outcome
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones; 0/Diuretics

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