Related Experiment Videos
Extensive spinal epidural hematoma: a rare complication of aortic coarctation
1Department of Radiology, Charles University Hospital, Hradec Králové, Czech Republic. zizka@fnhk.cz
Insights
Aortic coarctation can lead to spinal epidural hemorrhage from collateral vessels, causing sudden paralysis. This case highlights an unrecognized aortic coarctation as the cause of acute non-traumatic paraplegia in a young athlete.
Area of Science:
- Cardiovascular Medicine
- Neurology
- Vascular Surgery
Background:
- Aortic coarctation is a congenital heart defect characterized by narrowing of the aorta.
- Development of collateral circulation is a typical sign of aortic coarctation.
- Neurovascular complications, such as cerebral or spinal artery aneurysms, are common, increasing hemorrhage risk.
Observation:
- A 20-year-old sportsman presented with acute non-traumatic paraplegia.
- The paraplegia resulted from extensive spinal epidural hemorrhage.
- The hemorrhage originated from collateral vessels associated with previously unrecognized aortic coarctation.
Findings:
- This case represents the first reported instance of acute spinal epidural hematoma as a complication of aortic coarctation.
- The hemorrhage stemmed from collateral vessels developed due to the aortic narrowing.
- The underlying aortic coarctation remained undiagnosed until the catastrophic event.
Implications:
- This case underscores the importance of considering aortic coarctation in young individuals presenting with spontaneous spinal epidural hematoma.
- Recognizing and managing aortic coarctation can prevent severe neurological complications.
- Further research into the specific mechanisms of collateral vessel fragility in aortic coarctation is warranted.
Abstract:
Development of collateral circulation belongs among the typical signs of aortic coarctation. Cerebral or spinal artery aneurysm formation with increased risk of subarachnoid hemorrhage represent the most common neurovascular complication of this disease. We report a case of a 20-year-old sportsman who developed acute non-traumatic paraplegia as a result of extensive spinal epidural hemorrhage from collateral vessels accompanying aortic coarctation which was unrecognized up to that time. To the best of our knowledge, acute spinal epidural hematoma as a complication of aortic coarctation has not been previously reported.