Department of Intensive Care Medicine, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, 315000, Zhejiang, China.
Department of Intensive Care Medicine, Xiangshan Red Cross Taiwan Compatriot Hospital Medical and Health Group, Ningbo, 315000, Zhejiang, China.
BMC Anesthesiol. 2022 Aug 31;22(1):275. doi: 10.1186/s12871-022-01820-4.
Pulmonary embolism is a common cause of cardiac arrest. Pulmonary embolism-induced cardiac arrest typically suffers from ischemic injuries to various organs, including the central nervous system. However, spinal cord infarction is a rare complication of pulmonary embolism-induced cardiac arrest. At present, there is no case report on the occurrence of spinal cord infarction secondary to pulmonary embolism-induced cardiac arrest without accompanied cerebral complications.
A 72-year-old woman with dyspnea and chest tightness was admitted to the emergency room. Cardiac arrest occurred within a short period after admission. Subsequent computed tomographic pulmonary angiography revealed multiple pulmonary thromboses, which were highly suspected to be the cause of cardiac arrest. Thrombolytic therapy with alteplase was given after the return of spontaneous circulation. Unfortunately, she was found to be paraplegic in both lower extremities after regaining consciousness. Spinal cord infarction was confirmed by thoracic magnetic resonance imaging.
Despite receiving high-quality cardiopulmonary resuscitation, patients with cardiac arrest are at high risk of ischemic injury to the central nervous system. After the recovery of consciousness, clinicians should pay more attention to preclude the possibility of spinal cord infarction.
肺栓塞是心脏骤停的常见原因。肺栓塞引起的心脏骤停通常会导致包括中枢神经系统在内的各种器官缺血损伤。然而，脊髓梗死是肺栓塞引起的心脏骤停的罕见并发症。目前，尚无肺栓塞引起的心脏骤停而无脑并发症继发脊髓梗死的病例报告。
一名 72 岁女性因呼吸困难和胸闷就诊于急诊室。入院后不久即发生心脏骤停。随后的计算机断层肺动脉造影显示多发肺血栓，高度怀疑为心脏骤停的原因。自主循环恢复后给予重组组织型纤溶酶原激活物溶栓治疗。然而，患者意识恢复后被发现双下肢截瘫。胸椎磁共振成像证实为脊髓梗死。
尽管接受了高质量的心肺复苏，心脏骤停患者仍存在中枢神经系统缺血损伤的高风险。意识恢复后，临床医生应更加注意排除脊髓梗死的可能性。
