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Transient paraplegia caused by acute aortic dissection--case report
T Tanaka1, K Uemura, M Sugiura
1Department of Neurosurgery, Yaizu Municipal General Hospital, Shizuoka.
Neurologia Medico-Chirurgica
|January 1, 1990
Summary
Acute aortic dissection can mimic spinal cord issues, causing sudden back pain and paralysis. Prompt diagnosis is crucial for effective treatment and full recovery, as demonstrated in this case.
Area of Science:
- Cardiology
- Neurology
- Vascular Surgery
Background:
- Acute aortic dissection (AAD) is a life-threatening condition often presenting with chest pain.
- Neurological deficits can occur but are less common presentations of AAD.
Observation:
- A 66-year-old male with hypertension presented with sudden, transient paraplegia and severe back pain migrating to the neck.
- Imaging revealed aortic intimal calcification displacement, suggesting AAD, with no spinal abnormalities.
- Complete transverse myelopathy at the T9 level was noted.
Findings:
- The clinical presentation and imaging findings strongly indicated AAD with concurrent spinal cord ischemia.
- The patient's high blood pressure was managed, and pain was controlled.
- Full neurological recovery was achieved after 80 days of treatment.
Implications:
- This case highlights the importance of considering AAD in patients with acute back pain and neurological deficits.
- Differentiating AAD from primary spinal conditions is critical for timely intervention and improved patient outcomes.
- Early recognition and management of AAD can prevent irreversible neurological damage.