"I Can't Walk!" Acute Thrombosis of Descending Aorta Causing Paraplegia

Abstract

A 50-year-old man presented to the emergency department (ED) with acute, bilateral lower extremity weakness and loss of sensation, as well as absent pulses bilaterally. Computed tomography angiography showed complete occlusion of the aorta below the inferior mesenteric artery, extending to the iliac bifurcations. Echocardiographic findings showed severe systolic dysfunction (ejection fraction of 15%) and cryptic cardiogenic shock in spite of stable vital signs. Prior to early operative intervention, an early goal-oriented hemodynamic strategy of shock management resulted in the resolution of motor and sensory deficits.After definitive surgical intervention, the patient was discharged neurologically intact. Acute aortic occlusion is frequently accompanied by myocardial dysfunction, which can be from mild to severe. The most severe form can even occur with normal vital signs or occult cardiogenic shock. Early detection and goal-directed preoperative hemodynamic optimization, along with surgical intervention in the ED, is required to optimize outcomes.

Aortic thrombosis in dogs

“…Because of the relative rarity of ATE and ATh in people, there is no current consensus on treatment for these conditions. Case reports describe a variety of therapeutic approaches with generally similar positive outcomes . In veterinary medicine, theoretically ATE and ATh appear to be disease states where thrombolytic therapy would be the most applicable and potentially successful.…”

Paraplegia Due to Aortic Occlusion from a Fungal Ball

“…Acute aortic occlusion should be considered by the neurologist in the differential diagnosis of a patient who presents with the sudden onset of paraplegia, especially when this is associated with pain, pallor, or pulselessness. [6][7][8] Emergency embolectomy is optimal for revascularization. 6,8 In conclusion, the immunocompromised state of our patient following complicated intra-abdominal surgery with secondary candidemia ultimately led to fungal endocarditis and the acute occlusion of the aorta.…”

“…Acute aortic occlusion should be considered by the neurologist in the differential diagnosis of a patient who presents with the sudden onset of paraplegia, especially when this is associated with pain, pallor, or pulselessness. 6 7 8 Emergency embolectomy is optimal for revascularization. 6 8 …”

Leriche Syndrome in the Emergency Department: Two Case Reports

“…Leriche syndrome often occurs in males over 50 years of age, and it characteristically causes claudication in one or both lower extremities, absent or decreased femoral pulses, and erectile dysfunction in males [1,2]. In the literature, atypical findings such as paraplegia, urinary incontinence, flank pain, and shortness of breath have been reported according to the occluded level of the abdominal aorta [8][9][10]. The main treatment is surgery in LS, but angioplasty and endovascular stenting are the other treatment options in cases of focal involvement [11].…”