Paraparesis caused by transarterial chemoembolization: A case report

Area of Science:

• Hepatobiliary Medicine
• Interventional Radiology
• Neurology

Background:

• Transarterial chemoembolization (TACE) is a standard treatment for Hepatocellular Carcinoma (HCC).
• TACE is effective for small tumors and downstaging large tumors for liver transplantation.
• While generally safe, TACE can cause various side effects, including hepatic and gastrointestinal complications.

Purpose of the Study:

• To report an extremely rare case of spinal cord ischemia presenting as paraparesis following TACE.
• To investigate the potential cause of neurological deficit in the absence of typical embolic findings.

Main Methods:

• A case report detailing a patient who developed paraparesis after undergoing TACE for HCC.
• Diagnostic workup included imaging studies and nerve conduction studies.
• Evaluation focused on identifying the etiology of the neurological complication.

Main Results:

• The patient experienced paraparesis after TACE.
• Standard imaging and nerve conduction studies were normal, ruling out cerebral embolism or significant nerve damage.
• Findings suggested a rare complication of localized vasculitis affecting the spinal cord.

Conclusions:

• Spinal cord ischemia is a rare but severe complication of TACE.
• Normal imaging and nerve conduction studies in the presence of neurological deficits warrant further investigation for conditions like vasculitis.
• This case underscores the importance of considering uncommon etiologies for neurological complications post-TACE.