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Spinal cord lesion after penicillin gluteal injection
1Servizio di Medicina Fisica e Riabilitazione, Istituto Scientifico Ospedale San Raffaele, Milano, Italy.
Paraplegia
|June 1, 1992
Summary
Accidental penicillin gluteal injections can lead to irreversible paraplegia due to spinal infarction. This rare complication may result from the drug entering the superior gluteal artery, affecting spinal arteries.
Area of Science:
- Neurology
- Vascular Medicine
- Pharmacology
Background:
- Penicillin gluteal injections are associated with rare cases of sudden paraplegia.
- The underlying mechanism of this neurological complication remains unclear.
- Previous reports suggest spinal infarction as a potential cause.
Observation:
- Two additional cases of paraplegia following penicillin gluteal injection were observed.
- Patients experienced paralysis 6 and 16 years post-injection.
- Magnetic resonance imaging (MRI) revealed significant spinal atrophy in one patient.
Findings:
- Clinical presentation and MRI findings support the hypothesis of spinal infarction.
- A proposed mechanism involves accidental injection into the superior gluteal artery.
- This can lead to arterial spasm and embolic occlusion of the anterior spinal artery.
Implications:
- Highlights a potential risk associated with penicillin gluteal administration.
- Suggests a specific pathophysiological pathway for iatrogenic spinal cord injury.
- Emphasizes the need for careful injection techniques to prevent vascular complications.