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Recurrent, massive pulmonary embolism in chronic myelopathy: a case report.
MedLine Citation:
PMID:  20479769     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Study design:Case report.Objectives:The aim of this report was to describe an example of pulmonary embolism (PE), recently suggested to be highly prevalent in persons with chronic spinal cord lesions.Setting:Veterans Affairs Hospital, Boston, MA, USA.Methods:Chart review.Results:A 60-year-old man with paraplegia, T10 motor complete, underwent laminectomy for correction of an arteriovenous malformation. After 41 days, he sustained a massive PE-suggested by right bundle branch block (RBBB) on an electrocardiogram (ECG) and diagnosed by perfusion lung scanning. He was treated with anticoagulants, the lung scan and RBBB resolving within 1 month of initiating treatment. After 5 years, he developed vertebral osteomyelitis at L5-S1 and was treated with antibiotics and bed rest. After 7 days, he was mobilized to a wheelchair, and during a transfer back to bed, he developed anxiety, dyspnea, fluctuating consciousness, low blood pressure and RBBB, absent by ECG 4 days earlier. He expired 20 min after onset of symptoms. The autopsy revealed a fresh thromboembolus occluding both main stem branches of the pulmonary artery.Conclusion:Massive PE after surgery in a patient with chronic paraplegia recurred 5 years later in association with severe infection and mobilization after bed rest, which resulted in death.
Authors:
J H Frisbie; G V R K Sharma
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Publication Detail:
Type:  Journal Article     Date:  2010-05-18
Journal Detail:
Title:  Spinal cord : the official journal of the International Medical Society of Paraplegia     Volume:  49     ISSN:  1476-5624     ISO Abbreviation:  Spinal Cord     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-04     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9609749     Medline TA:  Spinal Cord     Country:  England    
Other Details:
Languages:  eng     Pagination:  318-20     Citation Subset:  IM    
Affiliation:
Research Service, VA Boston Healthcare System, and Harvard Medical School, Boston, MA, USA.
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