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一名急性B型主动脉夹层患者发生罕见的脊髓梗死。

Rare spinal cord infarction in a patient with acute type B aortic dissection.

作者信息

Sekine Yuji, Nishina Takeshi, Ueda Yuichi

机构信息

Department of Cardiovascular Surgery, Nara Prefecture General Medical Center, Nara, Japan.

出版信息

Interact Cardiovasc Thorac Surg. 2017 Jun 1;24(6):976-977. doi: 10.1093/icvts/ivx034.

Abstract

A 69-year-old man was admitted to our hospital with acute epigastric discomfort and subsequent paraplegia. Computed tomography revealed acute type B aortic dissection with a thrombosed false lumen. Magnetic resonance imaging did not reveal spinal cord infarction. Paraplegia resolved completely within 1 h. However, on the following day, the patient developed motor impairment in the left leg, sensory disorder of the bilateral legs and urinary retention. The symptoms gradually improved with conservative medical therapy. Magnetic resonance imaging on hospitalization Day 20 revealed spinal cord infarction limited to the right posterior area at level T7/T8 and the conus medullaris. The patient was discharged 44 days after admission. The presented case is notable for its atypical presentation of spinal cord infarction resulting from acute aortic dissection. The aetiology of neurological symptoms, especially that of lower extremity monoplegia, remained undiagnosed.

摘要

一名69岁男性因急性上腹部不适及随后出现的截瘫入住我院。计算机断层扫描显示为急性B型主动脉夹层,假腔有血栓形成。磁共振成像未显示脊髓梗死。截瘫在1小时内完全缓解。然而,次日患者出现左腿运动障碍、双下肢感觉障碍及尿潴留。经保守药物治疗,症状逐渐改善。住院第20天的磁共振成像显示脊髓梗死局限于T7/T8水平的右侧后部区域及脊髓圆锥。患者入院44天后出院。该病例因急性主动脉夹层导致脊髓梗死的非典型表现而值得关注。神经症状的病因,尤其是下肢单瘫的病因仍未明确。

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