Anterior spinal artery syndrome complicating aortic dissecting aneurysm: case report.
Spinal Cord ischaemia is rare in the absence of trauma. We report a case of a 45 year old known hypertensive for six years, who presented with features of anterior spinal artery syndrome (ASAS) complicating acute dissection of the descending aorta. He developed sudden onset non-traumatic paraparesis, sphincteric dysfunction and dissociated anaesthesia with a sensory level at T6. This was preceded by a two weeks' history of severe, sharp, lancinating, tearing left parasternal chest pain radiating to the back. He was managed conservatively on pentazocine lactate (fortwin), calcium- and beta-blockers, steroids, anti-platelet and free-radical scavengers. On the 8th day of hospitalisation, he had a sudden abdominal distension, bled from the nose and mouth, went into hypovolaemic shock and died within a time frame of two minutes. He was presumed to have had a progression of the aortic dissection with subsequent rupture. Dissecting aortic aneurysm could run a benign asymptomatic or a lethal course and a high index of suspicion is necessary. The lack of exhaustive diagnostic investigative tools as well as surgical intervention in the management of this patient in a developing country was highlighted as was possible that the patient could have been mismanaged.
Ogun
S A
SA
Department of Medicine, Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria.
Adefuye
B
B
Kolapo
K B
KB
Osalusi
B S
BS
D000784:Aortic Dissection / Q000150:complications*; D020759:Anterior Spinal Artery Syndrome / Q000209:etiology*; D001014:Aortic Aneurysm / Q000150:complications*; D017809:Fatal Outcome; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged