[Paraplegia following a transurethral prostate resection: the anterior spinal artery syndrome].
A 73-year-old man with an extensive cardiovascular risk profile and history underwent a transurethral resection of the prostate under spinal anaesthesia. The use of acetylsalicylic acid was stopped 10 days before the operation. No anaesthesiological or surgical complications occurred during the operation, but 6 hours after the operation the patient developed severe pain in both legs. Besides the hyperalgesia, there was a paresis and a reduced sensitivity of the legs. The patient had developed anterior spinal artery syndrome due to ischaemia of the lower thoracic myelum. Despite intensive rehabilitation this ultimately resulted in a residual disability and the patient became wheelchair bound. There seems to be a correlation between the patient's comorbidity, the stopping of the thrombocyte aggregation inhibitor and the occurrence of this particularly rare complication.
Vermin
Ben
B
Leids Universitair Medisch Centrum, afd. Anesthesiologie, Leiden, The Netherlands. b.vermin@lumc.nl
van Poorten
Frans
F
Stienstra
Rudolf
R
D000368:Aged; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D020759:Anterior Spinal Artery Syndrome / Q000209:etiology*; D001241:Aspirin / Q000008:administration & dosage; D006801:Humans; D008297:Male; D010264:Paraplegia / Q000209:etiology*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D011183:Postoperative Complications; D020760:Spinal Cord Ischemia / Q000150:complications*
D010975:Platelet Aggregation Inhibitors; D001241:Aspirin