[Two cases reports of neurologic complications after aortic aneurysm operation]

Two cases with dissecting aortic aneurysm of DeBakey type IIIb were treated by graft replacement of the descending thoracic aorta under temporary bypass (Heparinized Hydrophilic Polymer shunt tube) with concurrent somatosensory evoked potential (SEP) monitoring. The SEP was unchanged during operation in both cases, and three sets of intercostal or lumbar arteries were reattached in case 2. In case 1 anterior spinal artery syndrome occurred below the fourth thoracic level (T-4) and right side hemiplegia immediately after the operation. Case 2 had normal neurological function initially after recovering from anesthesia but showed Brown-Séquard syndrome below the first lumbar level (L-1) two days later. In both cases, neurologic disturbance gradually recovered, 19 months postoperatively, case 1 can walk with assistance, and case 2 is able to resume his former activity. The probability of the prevention of neurologic deficits is discussed.