Department of Neurosurgery, Affiliated Hospital and Clinical Medical College of Chengdu University, Chengdu, Sichuan, China.
Medicine (Baltimore). 2024 Aug 9;103(32):e39161. doi: 10.1097/MD.0000000000039161.
Spinal cord infarction is an uncommon nervous system disorder. We present a case of high cervical cord infarction caused by stenting of the origin of the left vertebral artery (VA). The incidence of spinal cord infarction is minimal, and it must be distinguished from a number of other disorders. The diagnosis is primarily based on imaging, clinical symptoms, and history. Currently, there is no focused treatment for spinal cord infarction. Thrombolysis, high-dose glucocorticoid shocks, tube dilatation to promote circulation, and nutritional neurotropic medicines given early in the course of the disease can all help to slow the disease's progression. There is no agreement on the etiology, diagnosis, or therapy options for these people.
On October 7, 2023, an 81-year-old man was admitted to the hospital primarily for recurrent chest tightness and pain that had persisted for more than 2 years and 1 month. Cerebral angiography upon admission revealed significant blockage of the right VA and stenosis of the left vertebral arterial origin. Six days following admission, a drug-eluting stenting procedure was carried out under local anesthesia to open the left VA origin via the femoral artery. Following the procedure, the patient experienced a progressive loss of muscle strength in all 4 limbs and paraplegia below the cervical 3 spinal cord. One week following the procedure, the patient was released from the hospital. After the procedure, the patient was released 1 week later. After the procedure, the patient's symptoms persisted for a month.
High awareness for high cervical cord infarction is required when neck discomfort and limb weakness with progressive progression arises after surgery. Complications of high cervical cord infarction following stenting for stenosis of VA origin are uncommon in clinical settings. Patients' prognoses can be improved by prompt diagnosis and care.
脊髓梗死是一种少见的神经系统疾病。我们报告了一例由左椎动脉(VA)起源部支架置入引起的高颈段脊髓梗死。脊髓梗死的发病率很低,必须与许多其他疾病相鉴别。诊断主要基于影像学、临床症状和病史。目前,脊髓梗死没有针对性的治疗方法。溶栓、大剂量糖皮质激素冲击、早期管腔扩张促进循环和营养神经药物的应用都有助于减缓疾病的进展。对于这些患者,病因、诊断和治疗选择尚无共识。
2023 年 10 月 7 日,一名 81 岁男性因反复出现胸闷和胸痛超过 2 年 1 个月而入院。入院时的脑血管造影显示右侧 VA 明显阻塞和左侧椎动脉起源部狭窄。入院后第 6 天行局部麻醉下经股动脉行药物洗脱支架置入术开通左侧 VA 起源部。术后,患者出现四肢肌力进行性下降和颈 3 脊髓以下截瘫。术后第 1 周,患者出院。出院后 1 周,患者症状持续。
当手术后出现颈痛和四肢无力并逐渐进展时,需要高度警惕高颈段脊髓梗死。VA 起源部狭窄支架置入术后并发高颈段脊髓梗死在临床上并不常见。及时诊断和治疗可改善患者的预后。