Özbek Hamdi Mehmet, Benli Emre Demir, Coşkun Sungur Elif, Sarıtaş Ahmet
Department of Cardiovascular Surgery, Sincan Training and Research Hospital, Ankara, Türkiye.
Department of Cardiovascular Surgery, Ankara City Hospital, Ankara, Türkiye.
Turk Gogus Kalp Damar Cerrahisi Derg. 2024 Dec 31;32(4 Suppl 2):129-130. doi: 10.5606/tgkdc.dergisi.2024.mep-30. eCollection 2024 Nov.
A Stanford type A aortic dissection is associated with elevated preoperative mortality and morbidity rates, as well as an increased likelihood of postoperative complications. Among these complications, paraplegia represents a serious but rare occurrence that can lead to significant morbidity in affected individuals. A 55-year-old male patient experienced acute paraplegia in the postoperative period after Stanford type A aortic dissection. Upon detection of paraplegia, medical therapy was promptly initiated. Despite maintenance of hemodynamic stability following surgery, the patient's neurological deficit persisted at 24 h postoperatively. In response, cerebrospinal fluid (CSF) drainage was performed. Notably, a full clinical recovery in neurological function was observed within 5 h of initiating CSF drainage. The pathophysiology underlying postoperative paraplegia in the context of aortic dissection remains unclear. However, with the maintenance of hemodynamic stability, appropriate medical management, and the persistence of neurological symptoms, the implementation of CSF drainage may be considered to facilitate resolution of symptoms. Emergent aortic surgeries can lead to devastating neurological complications. Among these complications, paraplegia can be managed successfully and considered a potentially reversible condition with these interventions.
斯坦福A型主动脉夹层与术前死亡率和发病率升高以及术后并发症的可能性增加相关。在这些并发症中,截瘫是一种严重但罕见的情况,可导致受影响个体出现显著的发病情况。一名55岁男性患者在斯坦福A型主动脉夹层术后出现急性截瘫。截瘫一经发现,立即开始药物治疗。尽管术后维持了血流动力学稳定,但患者的神经功能缺损在术后24小时仍持续存在。对此,进行了脑脊液引流。值得注意的是,在开始脑脊液引流后5小时内观察到神经功能完全临床恢复。主动脉夹层术后截瘫的病理生理学尚不清楚。然而,在维持血流动力学稳定、进行适当的药物管理且神经症状持续存在的情况下,可考虑实施脑脊液引流以促进症状缓解。急诊主动脉手术可导致毁灭性的神经并发症。在这些并发症中,截瘫可以通过这些干预措施成功治疗,并被认为是一种潜在可逆的情况。