Rare spinal cord infarction in a patient with acute type B aortic dissection.
A 69-year-old man was admitted to our hospital with acute epigastric discomfort and subsequent paraplegia. Computed tomography revealed acute type B aortic dissection with a thrombosed false lumen. Magnetic resonance imaging did not reveal spinal cord infarction. Paraplegia resolved completely within 1 h. However, on the following day, the patient developed motor impairment in the left leg, sensory disorder of the bilateral legs and urinary retention. The symptoms gradually improved with conservative medical therapy. Magnetic resonance imaging on hospitalization Day 20 revealed spinal cord infarction limited to the right posterior area at level T7/T8 and the conus medullaris. The patient was discharged 44 days after admission. The presented case is notable for its atypical presentation of spinal cord infarction resulting from acute aortic dissection. The aetiology of neurological symptoms, especially that of lower extremity monoplegia, remained undiagnosed.
Department of Cardiovascular Surgery, Nara Prefecture General Medical Center, Nara, Japan.
Yuji
Y
Sekine
Department of Cardiovascular Surgery, Nara Prefecture General Medical Center, Nara, Japan.
Takeshi
T
Nishina
Department of Cardiovascular Surgery, Nara Prefecture General Medical Center, Nara, Japan.
Yuichi
Y
Ueda
D000208:Acute Disease; D000368:Aged; D000784:Aortic Dissection / Q000150:complications* / Q000175:diagnosis; D017545:Aortic Aneurysm, Thoracic / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D007238:Infarction / Q000175:diagnosis / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D020760:Spinal Cord Ischemia / Q000175:diagnosis / Q000209:etiology*; D013904:Thoracic Vertebrae; D014057:Tomography, X-Ray Computed
Acute aortic dissection; Brown-Séquard syndrome; Posterior spinal artery syndrome; Spinal cord infarction