Paraplegia caused by coarctation of the aorta and hydrocephalus

A patient with untreated coarctation of the aorta, as well as shunt-dependent hydrocephalus, developed paraplegia when shunt malfunction resulted in a cerebrospinal fluid pressure greater than 560 mm water. Improvement followed shunt revision. The unique combination of mechanisms involved in the decreased spinal cord perfusion pressure is discussed.