The role of transesophageal echocardiography in the acute onset of paraplegia.
OBJECTIVE
Acute paraplegia must be investigated promptly to exclude reversible causes. In this report we illustrate the usefulness of transesophageal echocardiography in identifying the vascular etiologies of acute paraplegia.


METHODS
Two patients presented with acute paraplegia, one spontaneously and the other after removal of an intra-aortic balloon pump catheter. Through the use of transesophageal echocardiography, we excluded aortic dissection and identified protruding atherosclerotic plaques in the descending thoracic aorta of each patient. Embolization of atheromatous material from the thoracic aorta was considered the most likely etiology of paraplegia in both cases.


CONCLUSIONS
Embolization from atherosclerotic plaques in the thoracic aorta may be an underestimated cause of acute paraplegia. Transesophageal echocardiography provides a safe, rapid, and reliable tool for investigating a vascular etiology of acute paraplegia.
Walsh
D V
DV
Likoff Cardiovascular Institute, Department of Medicine, Hahnemann University Hospital, Philadelphia, PA 19102.
Uppal
J A
JA
Karalis
D G
DG
Chandrasekaran
K
K
D000368:Aged; D001018:Aortic Diseases / Q000150:complications / Q000000981:diagnostic imaging; D001161:Arteriosclerosis / Q000150:complications / Q000000981:diagnostic imaging; D004452:Echocardiography / Q000379:methods*; D004947:Esophagus; D005260:Female; D006801:Humans; D007238:Infarction / Q000150:complications / Q000175:diagnosis; D008279:Magnetic Resonance Imaging; D010264:Paraplegia / Q000000981:diagnostic imaging* / Q000209:etiology; D013116:Spinal Cord / Q000098:blood supply; D013997:Time Factors