Sakka S G, Hüttemann E
Klinik für Anästhesiologie und Intensivtherapie, Friedrich-Schiller-Universität Jena.
Dtsch Med Wochenschr. 2004 Jul 23;129(30):1622-4. doi: 10.1055/s-2004-829003.
A 70-year-old woman with acute chest pain was admitted to a hospital in stable cardiovascular conditions. The patient had no history of cardio-circulatory disease.
An acute myocardial infarction was excluded by ECG and blood tests. A computed tomography (CT) revealed an aortic dissection (Stanford type A) which extended to the left subclavian artery.
She was transferred to our institution and underwent urgent operation during which the ascending aorta and the proximal arch were replaced by a prosthesis. A few days after surgery, she developed progressive paresis of both legs. A control CT scan of the aorta revealed no evidence of a persisting aortic dissection. However, magnetic resonance tomography showed a meningioma of the thoracic spinal cord. The patient underwent surgical resection of the meningioma and her neurological symptoms diminished over the next few days.
Besides spinal ischemia, paresis of both legs after acute aortic dissection may be caused by rare lesions such as a thoracic meningioma.
一名70岁女性因急性胸痛入院，心血管状况稳定。该患者无心血管循环系统疾病史。
心电图及血液检查排除急性心肌梗死。计算机断层扫描（CT）显示主动脉夹层（斯坦福A型），延伸至左锁骨下动脉。
她被转至我院并接受紧急手术，术中升主动脉及近端主动脉弓被人工血管置换。术后几天，她出现双下肢进行性麻痹。主动脉的对照CT扫描未显示持续存在主动脉夹层的迹象。然而，磁共振断层扫描显示胸段脊髓有一个脑膜瘤。患者接受了脑膜瘤手术切除，接下来几天其神经症状有所减轻。
除脊髓缺血外，急性主动脉夹层后双下肢麻痹可能由罕见病变如胸段脑膜瘤引起。
