[Spinal cord infarction due to cholesterol emboli complicating intra-aortic balloon pumping (case report and review of the literature)].
A 62-year-old man with diabetes mellitus, hypertension, and hyperlipidemia was admitted to our hospital because of sudden onset of left chest pain. He was diagnosed with unstable angina with left heart failure and underwent intra-aortic balloon pumping (IABP) immediately. On the 3rd day after removal of the IABP (7th hospital day), he developed sudden paraplegia with pain. Spinal MRI on the 12th hospital day revealed a spinal swelling (Th11-L2). He was died of cardiac shock on the 19th hospital day. Autopsy examination of the spinal cord revealed a large infarct from the lower thoracic segment to the sacral segment. Microscopic examination of these areas disclosed occlusive emboli most frequently of the anterior spinal arteries including posterior spinal arteries. These emboli were found in two different forms, one consisting of new cholesterol emboli and the other of old atheromatous emboli. On autopsy, the aorta exhibited severe atherosclerosis with multiple ulcerative plaques, and there was infarction of the spleen. In our case, spinal cord infarction was caused by a massive amount of cholesterol crystals from the aorta related to IABP.
Sengoku
Renpei
R
Department of Neurology, Tokyo Saiseikai Central Hospital.
Hoshino
Haruhiko
H
Takagi
Makoto
M
Orikasa
Hideki
H
Yamazaki
Kazuto
K
D000789:Angina, Unstable / Q000628:therapy; D017700:Embolism, Cholesterol / Q000150:complications*; D006801:Humans; D007238:Infarction / Q000209:etiology*; D007423:Intra-Aortic Balloon Pumping / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D013116:Spinal Cord / Q000098:blood supply*