[Anatomo clinical aspects of a case of ischaemic necrosis of the spinal cord in a patient with a dissecting aneurysm of the aorta (author's transl)].
Neurological complications of dissecting aneurysm of the aorta are not frequently described in the literature. A case of infarction of the spinal cord secondary to aortic aneurysm is presented. The ischemic zone extended from D5-D6 to L2-L3, showing the typical double-funnel-like configuration. Such localization is explained by the blood circulation in the spinal cord. The rupture of a dissecting aortic aneurysm in the toracic and abdominal tract, by occluding the segmental branches to the spinal cord, causes a decrease in blood flow which is responsible for the neurological manifestations. In the present case ischemia is mainly due to the involvement of the artery of Adamkiewicz, while the relative sparing found at the inferior lumbar level is justified by the existence of vessels which take origin below the aneurysm and are tributary to the cauda equina. The histological findings are in agreement with previous observations of a selective necrosis of the gray matter.
D000784:Aortic Dissection; D001014:Aortic Aneurysm / Q000150:complications* / Q000473:pathology; D006801:Humans; D007511:Ischemia / Q000209:etiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D009461:Neurologic Manifestations; D013116:Spinal Cord / Q000098:blood supply* / Q000473:pathology
Considerazioni anatomocliniche su un caso di necrosi midollare ischemica conseguente ad aneurisma dissecante dell'aorta