Serdaroğlu Gül, Levent Ertürk, Yurtsever Serap, Calkavur Tanzer, Yünten Nilgün, Aydoğdu Sema
Department of Pediatrics, Ege University, Faculty of Medicine, Izmir, Turkey.
Turk J Pediatr. 2002 Jul-Sep;44(3):254-7.
We present a 15-year-old boy who developed sudden walking disability and sensory loss. He could not stand up on his feet and had no feeling following a sudden fall while playing basketball. He had been referred to a local hospital with these symptoms. In his physical examination absence of deep tendon reflexes and sensory loss were noted. His arterial blood pressure was 210/160 mmHg. He was transferred to our hospital with these findings and diagnosis of Guillain-Barré syndrome and hypertensive encephalopathy. There was sudden onset of sensory loss, walking disability and history of trauma. In the following hours hematuria, back pain and lower extremity ischemia developed. We suspected spinal artery injury based on the findings. Dissection of descending aorta was established with the help of magnetic resonance imaging of spinal region and contrasted aortography. The patient went to surgery immediately. He was lost on the second day after operation because of malperfusion. We report this case because dissecting aorta is very rare in the pediatric age group. High index of suspicion and early aortography are needed to diagnose aorta dissection.
我们报告一名15岁男孩，他出现了突然的行走障碍和感觉丧失。他在打篮球时突然摔倒后无法站立，且没有感觉。他因这些症状被转诊至当地医院。体格检查发现其深部腱反射消失和感觉丧失。他的动脉血压为210/160 mmHg。基于这些检查结果，他被转诊至我院，并被诊断为吉兰-巴雷综合征和高血压脑病。存在感觉丧失、行走障碍的突然发作以及外伤史。在接下来的几个小时里，出现了血尿、背痛和下肢缺血。基于这些发现，我们怀疑是脊髓动脉损伤。借助脊髓区域的磁共振成像和主动脉造影，确诊为降主动脉夹层。患者立即接受手术。术后第二天，他因灌注不良死亡。我们报告此病例是因为主动脉夹层在儿童年龄组中非常罕见。诊断主动脉夹层需要高度的怀疑指数和早期主动脉造影。
