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急性脊髓梗死伴腹侧灰质优先受累:尸检报告。

Acute Spinal Cord Infarction with Preferential Involvement of Ventral Gray Matter: An Autopsy Report.

机构信息

Department of Neurology, Nitobe Memorial Nakano General Hospital, 4-59-16, Chuo, Nakano-ku, Tokyo 164-8607, Japan.

The Faculty of Health Science Technology, Bunkyo Gakuin University, Japan.

出版信息

J Stroke Cerebrovasc Dis. 2020 Dec;29(12):105348. doi: 10.1016/j.jstrokecerebrovasdis.2020.105348. Epub 2020 Oct 15.

Abstract

Herein, we report abdominal aortic thrombosis as a rare cause of acute spinal cord infarction. A 78-year-old man with multiple vascular risk factors developed acute paraplegia with sensory and urinary disturbances and signs of ischemia in both lower limbs. The post-mortem study done 3 days after the onset of symptoms revealed a large coagulum in the abdominal aorta, distal to the renal arteries and extending to bilateral common iliac arteries; in addition, marked atherosclerosis was present in most large blood vessels. Premature incomplete necrotic foci were seen in the ventral gray matter of the spinal cord from T6 through S5; the surrounding white matter and dorsal gray matter were spared. Considering our autopsy case, spinal cord gray matter may be more vulnerable to ischemia than the white matter.

摘要

本文报道了一例罕见的因腹主动脉血栓形成导致的急性脊髓梗死。一名 78 岁男性,存在多种血管危险因素,突发急性截瘫,伴有感觉和排尿障碍,以及双下肢缺血迹象。症状发作后 3 天进行的尸检显示,在肾动脉以下的腹主动脉内有一大块血栓,延伸至双侧髂总动脉;此外,大多数大血管均存在明显的动脉粥样硬化。从 T6 到 S5 的脊髓腹侧灰质中可见到不成熟的不完全性坏死灶;周围的白质和背侧灰质未受累。考虑到我们的尸检病例,脊髓灰质可能比白质更容易发生缺血。

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