无痛性急性主动脉夹层导致的反复短暂性截瘫。
Repetitive transient paraplegia caused by painless acute aortic dissection.
作者信息
Takeda Shinsuke, Tanaka Yoshihiro, Sawada Yasuhiro, Tabuchi Akihiko, Hirata Hitoshi, Mizumoto Toru
机构信息
Emergency and Critical Care Center Anjo Kosei Hospital Anjo Japan.
Department of Hand Surgery Nagoya University Graduate School of Medicine Nagoya Japan.
出版信息
Acute Med Surg. 2019 Feb 19;6(2):188-191. doi: 10.1002/ams2.392. eCollection 2019 Apr.
CASE
Making a precise diagnosis of type A acute aortic dissection (AAD) presenting with atypical symptoms might be challenging for clinicians. Misdiagnosis and misuse of thrombolytic therapy can have devastating consequences.
OUTCOME
Herein, we report a case of painless type A AAD complicated by transient leg paresthesia, which was successfully treated with surgery. On admission, sudden onset of right leg numbness and muscle weakness was the only clue toward the correct final diagnosis.
CONCLUSION
When patients present with vague neurological symptoms, physicians should not rule out the possibility of AAD until proven otherwise.
病例
对于临床医生而言，准确诊断表现为非典型症状的A型急性主动脉夹层（AAD）可能具有挑战性。溶栓治疗的误诊和误用可能会带来灾难性后果。
结果
在此，我们报告一例无痛性A型AAD合并短暂性腿部感觉异常的病例，该病例通过手术成功治疗。入院时，右腿突然出现麻木和肌肉无力是做出正确最终诊断的唯一线索。
结论
当患者出现模糊的神经系统症状时，在排除其他可能性之前，医生不应排除AAD的可能性。
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