Ischaemic lumbosacral plexopathy in acute vascular compromise:case report

Abstract

This distinction is particularly difficult in the poly trauma patient with multiple musculo skeletal injuries or prolonged recuperation time, in addition to a vascular insult, as in this patient. The involved anatomical considerations will be discussed. A review of the elec trodiagnostic data from 30 patients, with lower extremity weakness following acute ischaemia, revealed a 20% incidence of spinal cord compromise, but no evidence of a plexopathy.

Paraplegia Following Type B Acute Aortic Dissection Can Spare the Spinal Cord

“…12e14 Various cases of even uncommoner causes of ischemic lumbosacral plexopathy have been reported, such as after acute or chronic thrombotic occlusion of abdominal aorta 15,16 or after severe prolonged hypotension. 17,18 However, we found only 2 cases of ischemic plexus involvement in acute TBAD. 7,8 García-Díaz et al 8 described in 1988 a patient with sudden onset of back pain and left crural weakness with absence of reflexes, and distal pulse preservation.…”

Spontaneous Recovery of Paraplegia in a Polytrauma Patient following Spinal Cord Ischemia due to Type B Traumatic Aortic Dissection

“…The theory that supports the presence of this collateral circulation is based on the small incidence of lumbar plexopathy after aortoiliac reconstruction [12][13][14]. Several cases have been reported associated with acute and chronic thrombotic events, also due to prolonged hypotension [15][16][17][18].…”

Bilateral ischemic lumbosacral plexopathy from chronic aortoiliac occlusion presenting with progressive paraplegia

“…Our patient showed a classic manifestation of lumbosacral plexopathy of paraparesis including variable sensory loss, hyporeflexia, and dysesthesias without bladder or bowel symptoms. 15 The electromyographic findings indicated mononeuropathy multiplex and axonotmesis. The etiology includes ischemic, demyelinating, infectious, and compression neuropathy, neoplastic or granulomatous infiltration, and other disorders, such as lumbosacral plexus neuropathy.…”

“…Also, various branches of the IIA, such as inferior gluteal artery via the arteria comitans nervi ischiadici and superior gluteal artery via the lateral sacral artery, feed the lumbosacral plexus. 15 These rich collaterals usually protect the lumbar plexus from ischemic injury even in the event of occlusion of most or all of the lumbar arteries.…”