73岁患者急性主动脉闭塞导致脊髓缺血：一例报告。
Acute aortic occlusion leading to spinal cord ischemia in a 73-year-old: A case report.
作者信息
Taghlabi Khaled M, Bhenderu Lokeshwar S, Guerrero Jaime R, Sulhan Suraj, Jenson Amanda V, Cruz-Garza Jesus G, Faraji Amir H
机构信息
Department of Neurological Surgery, Houston Methodist Hospital, Houston, United States.
出版信息
Surg Neurol Int. 2022 Dec 16;13:581. doi: 10.25259/SNI_898_2022. eCollection 2022.
BACKGROUND
Cauda equina syndrome (CES) is typically caused by a compressive etiology from a herniated disk, tumor, or fracture of the spine compressing the thecal sac. Here, we report a CES mimic - acute aortic occlusion (AAO), a rare disease that is associated with high morbidity and mortality. AAO can compromise spinal cord blood supply and leads to spinal cord ischemia.
CASE DESCRIPTION
Our patient presented with an acute onset of bilateral lower extremity pain and weakness with bowel/bladder incontinence, a constellation of symptoms concerning for CES. However, on initial imaging, there was no compression of his thecal sac to explain his symptomology. Further, investigation revealed an AAO. The patient underwent an emergent aortic thrombectomy with resolution of symptoms.
CONCLUSION
AAO can mimic CES and should be considered in one's differential diagnosis when imaging is negative for any spinal compressive etiologies.
背景
马尾综合征（CES）通常由椎间盘突出、肿瘤或脊柱骨折等压迫病因导致，压迫硬膜囊。在此，我们报告一种类似CES的疾病——急性主动脉闭塞（AAO），这是一种罕见疾病，与高发病率和死亡率相关。AAO可损害脊髓血供并导致脊髓缺血。
病例描述
我们的患者表现为急性双侧下肢疼痛、无力伴大小便失禁，这一系列症状提示CES。然而，初始影像学检查显示其硬膜囊无受压情况，无法解释其症状。进一步检查发现为AAO。患者接受了紧急主动脉血栓切除术，症状得以缓解。
结论
AAO可类似CES，当影像学检查未发现任何脊柱压迫病因时，应将其纳入鉴别诊断。
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