Article

Acute aortic dissection with painless paraplegia : report of 2 cases

Department of Emergency Medicine, Yeditepe University Hospital, Istanbul, Turkey.
The American journal of emergency medicine (Impact Factor: 1.15). 07/2008; 26(5):631.e3-5. DOI: 10.1016/j.ajem.2007.09.020
Source: PubMed

ABSTRACT Acute aortic dissection is often a life-threatening event that usually presents as a sudden, severe, exquisitely painful, ripping sensation in the chest or back. There are a few reports of atypical findings or no pain in the literature. We report 2 patients with painless acute aortic dissection who presented to the emergency department (ED) with sudden onset paraplegia.

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    • "Acute aortic coarctation with occlusion of the aorta is rare condition that has an extremely poor prognosis and high incidence of neurovascular complications. Paraplegia may be caused by intraspinal subarachnoid hemorrhage and spinal cord ischemia caused by aortic thrombosis and occlusion1,10,13). We present two cases admitted to our Emergency Department with flaccid paraplegia that were diagnosed with acute aortic coarctation and occlusion. "
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    ABSTRACT: Coarctation and occlusion of the aorta is a rare condition that typically presents with hypertension or cardiac failure. However, neuropathy or myelopathy may be the presenting features of the condition when an intraspinal subarachnoid hemorrhage has compressed the spinal cord causing ischemia. We report two cases of middle-aged males who developed acute non-traumatic paraplegia. Undiagnosed congenital abnormalities, such as aortic coarctation and occlusion, should be considered for patients presenting with nontraumatic paraplegia in the absence of other identifiable causes. Our cases suggest that spinal cord ischemia resulting from acute spinal subarachnoid hemorrhage and can cause paraplegia, and that clinicians must carefully examine patients presenting with nontraumatic paraplegia because misdiagnosis can delay initiation of the appropriate treatment.
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    ABSTRACT: This study is a case report. To report a case of a patient with paraplegia and low back pain, who was diagnosed with acute infrarenal aortic thrombosis. There have been few reports in the literature regarding acute aortic thrombosis presenting with paraplegia. A 56-year-old man was referred to our emergency department with flaccid paraplegia and low back pain. Clinical examination and imaging revealed acute infrarenal aortic thrombosis, with lower limb ischemia. The patient underwent transcutaneous embolectomy. Despite successful revascularization, the patient finally died because of development of revascularization syndrome. Acute aortic occlusion is a catastrophic event and may present with paraplegia, because of acute spinal cord ischemia. This can mislead the clinician to a wrong diagnosis and delay initiation of definite treatment.
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