title: Traumatic transection of the aorta and thoracic spinal cord injury without radiographic abnormality in an adult patient.
abstract: OBJECTIVE
  To describe a rare case of spinal cord injury without radiographic abnormalities (SCIWORA) associated with a traumatic aortic transection.
  
  
  METHODS
  A 48-year-old man was transferred for endovascular treatment of a traumatic aortic transection. Primary traumatic paraplegia had been documented at the scene of the accident. No osseous or ligamentous injuries were found in the conventional radiographic images. The transection was treated successfully with an endovascular stent-graft, but the patient remained paraplegic. On the magnetic resonance images 8 days later, discrete trauma of the intraspinal ligament at T1/T2 was seen, without signs of injury to the myelum. The patient made a slow but incomplete recovery after that.
  
  
  CONCLUSIONS
  SCIWORA very rarely affects the thoracic spinal cord in adults; therefore, a vascular injury in relation to the trauma of the aorta is assumed. When spinal cord damage is noted after stent-grafting or open aortic surgery for traumatic transection, SCIWORA should be ruled out by history and neurological examination.
authors.affiliation: Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353 Berlin, Germany. zipfel@dhzb.de
authors.forename: Burkhart
authors.initials: B
authors.lastname: Zipfel
authors.forename: Semih
authors.initials: S
authors.lastname: Buz
authors.forename: Dietrich
authors.initials: D
authors.lastname: Hullmeine
authors.forename: Rainer
authors.initials: R
authors.lastname: Röttgen
authors.forename: Roland
authors.initials: R
authors.lastname: Hetzer
mesh_terms: D000063:Accidents, Traffic; D001011:Aorta / Q000293:injuries* / Q000601:surgery; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010264:Paraplegia / Q000000981:diagnostic imaging / Q000209:etiology*; D013119:Spinal Cord Injuries / Q000000981:diagnostic imaging / Q000209:etiology*; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery