Extensive spinal epidural hematoma: a rare complication of aortic coarctation

Žižka, Ján; Eliás, P; Michl, A; Harrer, Jan; Česák, Tomáš; Herman, Annette

doi:10.1007/s003300000732

Cited by 14 publications

(1 citation statement)

References 7 publications

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“…Aortic coarctation with secondary intraspinal epidural hemorrhage is extremely uncommon. A PubMed literature search revealed only two cases of spinal epidural hemorrhage and three cases of spinal subarachnoid hemorrhage associated with aortic coarctation (Table 1) [1–5]. We describe a case of chest pain followed by paraplegia at the time of ED presentation.…”

Section: Introductionmentioning

confidence: 99%

Chest Pain and Sudden-Onset Paraplegia at the Emergency Department: An Uncommon Presentation

Chiu

Tsai

2017

Am J Case Rep

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Patient: Male, 45Final Diagnosis: Acute coarctation with spinal epidural hemorrhageSymptoms: Chest pain with bilateral lower limbs pareplegiaMedication: —Clinical Procedure: Percutaneous transluminal angioplasty and thoracic endovascular repair followed by bilateral hemilaminectomySpecialty: SurgeryObjective:Rare diseaseBackground:Coarctation of the aorta is characterized by narrowing of the descending aorta. The narrowing typically is at the isthmus, the segment just distal to the left subclavian artery. Adults with undiagnosed aortic coarctation are asymptomatic or may present with nonspecific hypertension. We present a case that highlights the uncommon complication of aortic coarctation with spinal compression syndrome.Case Report:A 45-year-old male presented to the emergency department (ED) with acute-onset chest pain; he experienced urinary incontinence and bilateral lower limb weakness during his ED visit. Chest CT showed coarctation of the aorta and MRI of the spine showed an epidural nodular lesion. He received emergency aortic stent placement surgery, followed by successful hematoma removal and was discharged with residual lower-extremity paraplegia.Conclusions:Chest pain with lower limb paraplegia presentation should consider aortic coarctation complicated with spinal hemorrhage as a possible cause.

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Section: Introductionmentioning

confidence: 99%

Chest Pain and Sudden-Onset Paraplegia at the Emergency Department: An Uncommon Presentation

Chiu

Tsai

2017

Am J Case Rep

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Optic pathway gliomas

Jahraus¹,

Tarbell²

2006

Pediatric Blood & Cancer

158

105

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Optic pathway gliomas represent approximately 5% of all pediatric intracranial tumors. While these tumors are most frequently low grade astrocytomas, they follow a highly variable clinical course, and accordingly, there is much debate regarding their optimal management. Their propensity to occur in very young children and infants further complicates selection of therapy. Historically, surgery and radiotherapy have played a primary role in management, however, in the last 15 years, chemotherapy has evolved into the first-line treatment of choice. Nonetheless, chemotherapy frequently fails, but serves to delay implementation of radiotherapy or surgery until the child has progressed neuropsychologically. An overall favorable prognosis for this tumor emphasizes the need for careful selection of therapy. Herein, we review the major features of optic pathway glioma, including epidemiology, pathology, therapeutic interventions, outcome, and treatment sequelae.

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Persistent cervical intersegmental artery and aortic arch coarctation

Glunčić

Lukić

Kopljar

et al. 2002

Surgical and Radiologic Anatomy

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A 15-year-old girl presented with upper extremity hypertension and continuous precordial murmur. Arteriography revealed aortic coarctation proximal to the origin of the left subclavian artery. An anomalous artery originated from the aortic arch, between the left common carotid artery and the stenosis. It ascended cranially and filled an angiomatous vascular formation on the left side of the neck. The "angioma" drained into the left subclavian artery. The embryological explanation of the described anomaly is difficult, but probably related to hemodynamic alterations following the prestenotic increase in blood pressure. This may have impaired the obliteration of cervical intersegmental arteries, resulting in the persistence of one of the first three intersegmental arteries as the anomalous branch of the aortic arch. The angiomatous vascular formation in the neck could be the consequence of altered development of anastomoses between the muscular twigs of both vertebral and deep cervical artery. The vessel draining the vascular formation was probably the thyrocervical trunk. Since there were no overt collateral channels or signs of left ventricular hypertrophy by electrocardiography and echocardiography, it seems that the aberrant collateral flow was hemodynamically significant and reduced the afterload on the myocardium. Although the pattern of collateral flow in our case might be considered extremely rare, it is important in preoperative planning and interpretation of imaging studies.

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Extensive spinal epidural hematoma: a rare complication of aortic coarctation

Cited by 14 publications

References 7 publications

Chest Pain and Sudden-Onset Paraplegia at the Emergency Department: An Uncommon Presentation

Chest Pain and Sudden-Onset Paraplegia at the Emergency Department: An Uncommon Presentation

Optic pathway gliomas

Persistent cervical intersegmental artery and aortic arch coarctation

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