DOI QR코드

DOI QR Code

Paraplegia due to Acute Aortic Coarctation and Occlusion

  • Park, Chang-Bum (Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine) ;
  • Jo, Dae-Jean (Department of Neurosurgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine) ;
  • Kim, Min-Ki (Department of Neurosurgery, Kyung Hee University Hospital, Kyung Hee University School of Medicine) ;
  • Kim, Sang-Hyun (Department of General Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine)
  • 투고 : 2013.03.27
  • 심사 : 2014.01.10
  • 발행 : 2014.03.28

초록

Coarctation and occlusion of the aorta is a rare condition that typically presents with hypertension or cardiac failure. However, neuropathy or myelopathy may be the presenting features of the condition when an intraspinal subarachnoid hemorrhage has compressed the spinal cord causing ischemia. We report two cases of middle-aged males who developed acute non-traumatic paraplegia. Undiagnosed congenital abnormalities, such as aortic coarctation and occlusion, should be considered for patients presenting with nontraumatic paraplegia in the absence of other identifiable causes. Our cases suggest that spinal cord ischemia resulting from acute spinal subarachnoid hemorrhage and can cause paraplegia, and that clinicians must carefully examine patients presenting with nontraumatic paraplegia because misdiagnosis can delay initiation of the appropriate treatment.

키워드

참고문헌

  1. Aktas C, Cinar O, Ay D, Gürses B, Hasmanoglu H : Acute aortic dissection with painless paraplegia : report of 2 cases. Am J Emerg Med 26 : 631.e3-631.e5, 2008
  2. Banna MM, Rose PG, Pearce GW : Coarctation of the aorta as a cause of spinal subarachnoid hemorrhage. Case report. J Neurosurg 39 : 761-763, 1973 https://doi.org/10.3171/jns.1973.39.6.0761
  3. Blaisdell FW, Steele M, Allen RE : Management of acute lower extremity arterial ischemia due to embolism and thrombosis. Surgery 84 : 822-834, 1978
  4. Campbell M : Natural history of coarctation of the aorta. Br Heart J 32 : 633-640, 1970 https://doi.org/10.1136/hrt.32.5.633
  5. Domenicucci M, Ramieri A, Paolini S, Russo N, Occhiogrosso G, Di Biasi C, et al. : Spinal subarachnoid hematomas : our experience and literature review. Acta Neurochir (Wien) 147 : 741-750; discussion 750, 2005 https://doi.org/10.1007/s00701-004-0458-2
  6. Edwards KC, Katzen BT : Superior mesenteric artery syndrome due to large dissecting abdominal aortic aneurysm. Am J Gastroenterol 79 : 72-74, 1984
  7. Godart F : Intravascular stenting for the treatment of coarctation of the aorta in adolescent and adult patients. Arch Cardiovasc Dis 104 : 627-635, 2011 https://doi.org/10.1016/j.acvd.2011.08.005
  8. Hino H, Maruyama H, Inomata H : A case of spinal artery aneurysm presenting transverse myelopathy associated with coarctation of the aorta. Rinsho Shinkeigaku 29 : 1009-1012, 1989
  9. Hölper P, Hyhlik-Dürr A, Kotelis D, von Tengg-Kobligk H, Böckler D : Paraplegia after spontaneous dissection of the abdominal aorta. Vasa 38 : 254-258, 2009 https://doi.org/10.1024/0301-1526.38.3.254
  10. Inamasu J, Hori S, Yokoyama M, Funabiki T, Aoki K, Aikawa N : Paraplegia caused by painless acute aortic dissection. Spinal Cord 38 : 702-704, 2000 https://doi.org/10.1038/sj.sc.3101087
  11. Karacostas D, Anthomelides G, Ioannides P, Psaroulis K, Psaroulis D : Acute paraplegia in painless aortic dissection. Rich imaging with poor outcome. Spinal Cord 48 : 87-89, 2010 https://doi.org/10.1038/sc.2009.70
  12. Kelley CE : Nontraumatic abdominal aortic thrombosis presenting with anterior spinal artery syndrome and pulmonary edema. J Emerg Med 9 : 233-237, 1991 https://doi.org/10.1016/0736-4679(91)90418-F
  13. Kochar G, Kotler MN, Hartman J, Goldberg SE, Parry W, Parameswaran R, et al. : Thrombosed aorta resulting in spinal cord ischemia and paraplegia in ischemic cardiomyopathy. Am Heart J 113 : 1510-1513, 1987 https://doi.org/10.1016/0002-8703(87)90670-3
  14. Lins E, Vlajic I, Wappenschmidt J : Spinal subarachnoid hemorrhage in a case of stenosis of the aorta (author's transl). Rontgenblatter 30 : 239-244, 1977
  15. Lusby RJ, Wylie EJ : Acute lower limb ischemia : pathogenesis and management. World J Surg 7 : 340-386, 1983 https://doi.org/10.1007/BF01658082
  16. Nandeesh BN, Mahadevan A, Santosh V, Yasha TC, Shankar SK : Acute aortic dissection presenting as painful paraplegia. Clin Neurol Neurosurg 109 : 531-534, 2007 https://doi.org/10.1016/j.clineuro.2007.03.010
  17. O'Dell KB, Hakim SN : Dissecting thoracic aortic aneurysm in a 22-year-old man. Ann Emerg Med 19 : 316-318, 1990 https://doi.org/10.1016/S0196-0644(05)82053-0
  18. Poirée S, Monnier-Cholley L, Tubiana JM, Arrivé L : Acute abdominal aortic thrombosis in cancer patients. Abdom Imaging 29 : 511-513, 2004
  19. Surowiec SM, Isiklar H, Sreeram S, Weiss VJ, Lumsden AB : Acute occlusion of the abdominal aorta. Am J Surg 176 : 193-197, 1998 https://doi.org/10.1016/S0002-9610(98)00129-9
  20. Swan L, Wilson N, Houston AB, Doig W, Pollock JC, Hillis WS : The long-term management of the patient with an aortic coarctation repair. Eur Heart J 19 : 382-386, 1998 https://doi.org/10.1053/euhj.1997.0557
  21. Triantafyllopoulos GK, Athanassacopoulos M, Maltezos C, Pneumaticos SG : Acute infrarenal aortic thrombosis presenting with flaccid paraplegia. Spine (Phila Pa 1976) 36 : e1042-e1045, 2011 https://doi.org/10.1097/BRS.0b013e3181fee67f
  22. Watson AB : Spinal subarachnoid haemorrhage in patient with coarctation of aorta. Br Med J 4 : 278-279, 1967 https://doi.org/10.1136/bmj.4.5574.278
  23. Webb KH, Jacocks MA : Acute aortic occlusion. Am J Surg 155 : 405-407, 1988 https://doi.org/10.1016/S0002-9610(88)80100-4

피인용 문헌

  1. Paraplegia Due to Aortic Occlusion from a Fungal Ball vol.17, pp.1, 2014, https://doi.org/10.3988/jcn.2021.17.1.150