| Paraplegia after spontaneous dissection of the abdominal aorta. | |
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MedLine Citation:
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PMID: 19736638 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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P H??lper; A Hyhlik-D??rr; D Kotelis; H von Tengg-Kobligk; D B??ckler |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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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:
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Created Date: 2009-09-08 Completed Date: 2009-10-15 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0317051 Medline TA: Vasa Country: Switzerland |
Other Details:
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Languages: eng Pagination: 254-8 Citation Subset: IM |
Affiliation:
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Klinik f??r Gef??sschirurgie, Universit??t Heidelberg, Germany. Peter.Hoelper@med.uni-heidelberg |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adrenal Cortex Hormones
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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:
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0/Adrenal Cortex Hormones; 0/Diuretics |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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