Painless Dissecting Aneurysm of the Aorta Presenting as Simultaneous Cerebral and Spinal Cord Infarctions.
10.3340/jkns.2011.50.3.252
- Author:
Jae Yoel KWON
1
;
Jae Hoon SUNG
;
Il Sup KIM
;
Byung Chul SON
Author Information
1. Department of Neurosurgery, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea. jaehoonsung@gmail.com
- Publication Type:Case Report
- Keywords:
Aorta;
Dissecting aneurysm;
Cerebral infarction;
Spinal cord ischemia
- MeSH:
Aneurysm, Dissecting*;
Angiography;
Aorta*;
Aorta, Thoracic;
Arm;
Brain;
Brain Infarction;
Cerebral Infarction;
Diagnosis;
Hemodynamics;
Hemorrhage;
Humans;
Hypotension;
Infarction*;
Ischemia;
Magnetic Resonance Imaging;
Paraplegia;
Paresis;
Perfusion;
Spinal Cord Ischemia;
Spinal Cord*;
Spine;
Thrombolytic Therapy;
Transplants
- From:Journal of Korean Neurosurgical Society
2011;50(3):252-255
- CountryRepublic of Korea
- Language:English
-
Abstract:
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.
