[Paraplegia after acute thoracic pain].
Severe neurological complications such as spinal cord ischemia and paraplegia can occur with acute aortic dissection in 3%. This report describes the case of a 67-year old patient with delayed onset of paraplegia 8 h after acute chest pain. Contrast enhanced computed tomography documented Stanford type B dissection confined to a short segment of the aorta. Furthermore, magnetic resonance imaging revealed intraspinal intraaxial hematoma of the myelon, which can explain the neurological complication. This case shows that even in the scenario of acute aortic dissection other mechanisms for paraplegia may be operational than dissection itself. Paraplegia in this case results from intramyelon bleeding preceding aortic dissection.
Kleinfeldt
T
T
Klinik und Poliklinik für Innere Medizin, Universität Rostock, Ernst-Heydemannstrasse 6, 18057 Rostock. tilo.kleinfeldt@gmx.de
Rehders
T C
TC
Raab
U
U
Ince
H
H
Nienaber
C A
CA
D000208:Acute Disease; D000368:Aged; D000784:Aortic Dissection / Q000150:complications* / Q000175:diagnosis; D001014:Aortic Aneurysm / Q000150:complications* / Q000175:diagnosis; D002637:Chest Pain / Q000175:diagnosis / Q000209:etiology*; D003937:Diagnosis, Differential; D005260:Female; D046649:Hematoma, Subdural, Spinal / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D010264:Paraplegia / Q000175:diagnosis / Q000209:etiology*