Acute aortic dissection with painless paraplegia: report of 2 cases

Aktaş, Can; Çınar, Orhan; Ay, Dıdem; Gürses, Bengı; Hasmanoglu, Hakan

doi:10.1016/j.ajem.2007.09.020

Cited by 13 publications

(11 citation statements)

References 11 publications

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“…Possible etiologies include in situ thrombosis, aortic saddle embolus, and an intimal flap that causes aortic dissection and thrombosis9,16,19). Aortic dissection and reparative vascular surgery are well-established causes of spinal cord ischemia1,9,10,11,16). Investigations of the relationship between paraplegia and acute aortic thrombosis have suggested that aortic thrombosis may be caused by in situ thrombosis, cancer, chemotherapy ischemic cardiomyopathy13,18,19,21,23).…”

Section: Discussionmentioning

confidence: 99%

“…However, cases of intestinal ischemia6,17) and painless paraplegia1,10) have been reported. Aggressive medical treatment must be administered to patients who show evidence of intestinal ischemia on radiographic evaluation.…”

Section: Discussionmentioning

confidence: 99%

“…Paraplegia may be caused by intraspinal subarachnoid hemorrhage and spinal cord ischemia caused by aortic thrombosis and occlusion1,10,13). We present two cases admitted to our Emergency Department with flaccid paraplegia that were diagnosed with acute aortic coarctation and occlusion.…”

Section: Introductionmentioning

confidence: 94%

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Paraplegia due to Acute Aortic Coarctation and Occlusion

Park

Minki

et al. 2014

J Korean Neurosurg Soc

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Coarctation and occlusion of the aorta is a rare condition that typically presents with hypertension or cardiac failure. However, neuropathy or myelopathy may be the presenting features of the condition when an intraspinal subarachnoid hemorrhage has compressed the spinal cord causing ischemia. We report two cases of middle-aged males who developed acute non-traumatic paraplegia. Undiagnosed congenital abnormalities, such as aortic coarctation and occlusion, should be considered for patients presenting with nontraumatic paraplegia in the absence of other identifiable causes. Our cases suggest that spinal cord ischemia resulting from acute spinal subarachnoid hemorrhage and can cause paraplegia, and that clinicians must carefully examine patients presenting with nontraumatic paraplegia because misdiagnosis can delay initiation of the appropriate treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Paraplegia due to Acute Aortic Coarctation and Occlusion

Park

Minki

et al. 2014

J Korean Neurosurg Soc

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“…Pain is present in more than 90% of the patients with the disease. Paraplegia resulting from dissection of the descending aorta is rare, occurring in 2% to 8% of patients [1,2] Aortic dissection presenting only with signs and symptoms of acute spinal cord damage is distinctly rare [3,4]. On the other hand, the diagnosis of aortic dissection in patients with acute paraplegia is frequently missed [5,6] Therefore, aortic dissection should be considered in the differential diagnosis of acute paraplegia with or without back pain.…”

mentioning

confidence: 97%

Spinal cord infarct as the primary presentation of aortic dissection

Silva¹,

Valiente²

2014

The Spine Journal

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“…Aortic dissection commonly presents with severe chest pain that may radiate to the back although painless dissections have been reported. [1][2][3][4][5] While up to a third of acute aortic dissections present with neurological symptoms, a small minority present with spinal cord ischaemia: anterior spinal artery syndrome is a rare presentation -only 2-8% present with paraplegia with or without sensory loss. 6,7 Case presentation…”

Section: Abstract Backgroundmentioning

confidence: 99%

Anterior Spinal Artery Syndrome from Type a Aortic Dissection in a Patient with Marfan Syndrome Due to a Novel Fibrillin Mutation

Cheng

Perenyei

Sayeed

2018

Journal of the Royal College of Physicians of Edinburgh

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Type A aortic dissection is a rare but important cardiac surgical emergency. Few reports exist in the literature describing anterior spinal artery syndrome as a presenting feature.We report a case of anterior spinal artery syndrome due to aortic dissection in a patient with Marfan syndrome caused by a novel brillin mutation. A 53-year old female presented with chest pain and sudden-onset paralysis. Neurological examination revealed normal upper limb examination, reduced lower limb power and re exes but normal sensation. CT scanning revealed type A acute aortic dissection which was treated with emergent cardiac surgical repair. At clinic follow up 3 years later, signs of Marfan syndrome were opportunistically noted and genetic testing revealed a novel mutation in the Fibrillin 1 gene. This case emphasises the importance of a good initial clinical assessment, including thorough neurological examination, as well as a low threshold of clinical suspicion for an aortic dissection in such a constellation of symptoms. The importance of family history should also be emphasised given the coincidental diagnosis of Marfan syndrome in a rst-degree relative. Furthermore, this case illustrates the classical signs of anterior spinal artery syndrome.

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Acute aortic dissection with painless paraplegia: report of 2 cases

Cited by 13 publications

References 11 publications

Paraplegia due to Acute Aortic Coarctation and Occlusion

Paraplegia due to Acute Aortic Coarctation and Occlusion

Spinal cord infarct as the primary presentation of aortic dissection

Anterior Spinal Artery Syndrome from Type a Aortic Dissection in a Patient with Marfan Syndrome Due to a Novel Fibrillin Mutation

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