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Myelopathy and multiple aneurysms associated with aortic arch interruption: case report

F Ling¹, Y H Bao

¹Interventional Neuroradiology Training Center, Beijing Hospital, China.

|August 1, 1994

Summary

This case study highlights a rare combination of neurological conditions and aortic arch interruption in a young patient. Surgical correction of the aortic defect led to some neurological improvement, offering insights into hemodynamic effects on the central nervous system.

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Area of Science:

Neurology
Cardiovascular Surgery
Radiology

Background:

A 14-year-old male presented with a 2-year history of flaccid paraplegia and incontinence following two subarachnoid hemorrhages.
The patient exhibited an unusual constellation of conditions: multiple cranial and spinal aneurysms, anterior spinal artery syndrome, syringomyelia, and aortic arch interruption.

Observation:

The patient's survival into adolescence with aortic arch interruption provided a unique opportunity to study collateral circulation and hemodynamic effects on the central nervous system.
Extensive physical and neuroradiological investigations confirmed the complex association of vascular and neurological abnormalities.

Findings:

Surgical intervention focused on correcting the hemodynamic abnormality of the aortic arch interruption.

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Bypass surgery from the ascending aorta to the abdominal aorta using a synthetic graft was performed.

Implications:

The patient demonstrated neurological improvement post-surgery, with a lowered sensory level from T7 to L1.
This case underscores the importance of addressing hemodynamic abnormalities in complex congenital conditions and offers insights into the central nervous system's response.