Journal of Korean Neurosurgical Society

  • 제50권3호
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  • Pages.252-255
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  • 2011
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Painless Dissecting Aneurysm of the Aorta Presenting as Simultaneous Cerebral and Spinal Cord Infarctions

  • Kwon, Jae-Yoel (Department of Neurosurgery, St. Vincent's Hospital, The Catholic University of Korea College of Medicine) ;
  • Sung, Jae-Hoon (Department of Neurosurgery, St. Vincent's Hospital, The Catholic University of Korea College of Medicine) ;
  • Kim, Il-Sup (Department of Neurosurgery, St. Vincent's Hospital, The Catholic University of Korea College of Medicine) ;
  • Son, Byung-Chul (Department of Neurosurgery, St. Vincent's Hospital, The Catholic University of Korea College of Medicine)
  • 투고 : 2011.03.25
  • 심사 : 2011.09.05
  • 발행 : 2011.09.28
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초록

Authors report a case of a painless acute dissecting aneurysm of the descending aorta in a patient who presented with unexplained hypotension followed by simultaneous paraplegia and right arm monoparesis. To our knowledge, case like this has not been reported previously. Magnetic resonance imaging of the brain and spine revealed hemodynamic cerebral infarction and extensive cord ischemia, respectively. Computerized tomography angiography confirmed a dissecting aneurysm of the descending aorta. The cause of the brain infarction may not have been embolic, but hemodynamic one. Dissection-induced hypotension may have elicited cerebral perfusion insufficiency. The cause of cord ischemia may be embolic or hemodynamic. The dissected aorta was successfully replaced into an artificial patch graft. The arm monoparesis was improved, but the paraplegia was not improved. In rare cases of brain and/or spinal cord infarction caused by painless acute dissecting aneurysm of the aorta, accurate diagnosis is critical because careless thrombolytic therapy can result in life-threatening bleeding.

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참고문헌

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피인용 문헌

  1. Aortic Dissection Presenting Primarily as Acute Spinal Cord Damage: A Case Report and Literature Review vol.40, pp.5, 2012, https://doi.org/10.1177/030006051204000544
  2. Aortic Dissection Complicated with Fatal Cerebral Infarction: Case Report and Review of Literatures vol.2, pp.2, 2011, https://doi.org/10.4236/ojmn.2012.22005
  3. Acute aortic dissection presenting as painless paraplegia: a case report vol.10, pp.1, 2016, https://doi.org/10.1186/s13256-016-0881-z
  4. Successful Reversal of Delayed Postoperative Paraplegia Complicating Emergency Total Arch Replacement for Type A Dissection vol.48, pp.2, 2011, https://doi.org/10.4326/jjcvs.48.147