Traumatic transection of the aorta and thoracic spinal cord injury without radiographic abnormality in an adult patient.
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.
Zipfel
Burkhart
B
Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353 Berlin, Germany. zipfel@dhzb.de
Buz
Semih
S
Hullmeine
Dietrich
D
Röttgen
Rainer
R
Hetzer
Roland
R
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