He Runcheng, Huang Qing, Yan Xinxiang, Liu Yunhai, Yang Jie, Chen Xiaobin
Department of Neurology, Xiangya Hospital, Central South University, Changsha, China.
National Clinical Research Center for Geriatric Disorders, Changsha, China.
Front Neurol. 2019 Feb 22;10:137. doi: 10.3389/fneur.2019.00137. eCollection 2019.
We report a case of a 66-year-old female who burst into flaccid paralysis of the lower extremities, accompanied by loss of pain and temperature sensation below T4 level, during an oxygen-ozone injection for disc herniation. Half an hour later, she suffered from chest pain. Magnetic resonance imaging (MRI) showed long segment hyperintensity in the thoracic spinal cord from T2 to 10 level on sagittal T2-weighted images (T2WI). The electrocardiogram (ECG) showed ST-segment elevation in V1-V6 leads. She was diagnosed with spinal cord infarction and ST-elevation myocardial infarction (STEMI). Transthoracic echocardiography with saline contrast showed existence of a large patent foramen ovale (PFO) correlating with the detection of massive microbubbles in the left atrium. We discuss the potential role of paradoxical embolism in spinal cord infarction and myocardial infarction.
我们报告一例66岁女性病例，该患者在进行椎间盘突出症臭氧注射治疗期间突然出现双下肢弛缓性瘫痪，并伴有T4水平以下痛觉和温度觉丧失。半小时后，她出现胸痛。磁共振成像（MRI）矢状位T2加权像（T2WI）显示胸段脊髓从T2至T10水平呈长节段高信号。心电图（ECG）显示V1-V6导联ST段抬高。她被诊断为脊髓梗死和ST段抬高型心肌梗死（STEMI）。经胸超声心动图盐水造影显示存在一个大的卵圆孔未闭（PFO），与左心房内大量微泡的检测相关。我们讨论了反常栓塞在脊髓梗死和心肌梗死中的潜在作用。
