Yoshimura M, Uchigata M, Shimizu S, Sakamoto T, Murayama S
Department of Neurology, Showa General Hospital.
Rinsho Shinkeigaku. 2000 Oct;40(10):1038-40.
A seventy-six-year-old man suddenly suffered from paraplegia and pain in both legs. He had been maintained on hemodialysis and committed a suicide attempt by cutting the shunt at the paraplegic attack. He was brought to the emergency ward for the treatment of hemorrhagic preshock. Neurological examination demonstrated flaccid paraplegia, loss of tendon reflex in the lower extremities, dissociated sensory loss below the fourth lumbar level; and incontinence in defecation. MRI showed T2 shortening in the ventral spinal cord caudal below the level of the eleventh thoracic cord. Postmortem examination confirmed ischemic infarct in the central area of the spinal cord, associated with disseminated cholesterin emboli in the small arteries. This case was the first MRI demonstration of central necrosis caused by cholesterin emboli, and may emphasize the significance of cholesterin emboli in the spinal arterial disorders in the aged.
一名76岁男性突然出现双下肢截瘫和疼痛。他一直在接受血液透析治疗，在截瘫发作时试图通过切断分流管自杀。他因失血性休克前期被送往急诊病房治疗。神经系统检查显示弛缓性截瘫、下肢腱反射消失、第4腰椎水平以下分离性感觉丧失以及大便失禁。磁共振成像（MRI）显示胸11水平以下脊髓腹侧尾端T2信号缩短。尸检证实脊髓中央区域存在缺血性梗死，并伴有小动脉内散在的胆固醇栓子。该病例是首次通过MRI显示胆固醇栓子导致的中央坏死，可能凸显了胆固醇栓子在老年人脊髓动脉疾病中的重要性。
