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Rehabilitation Practice and Science

Translated Title

無痛性主動脈剝離引發進行性缺血性脊髓病變：病例報告

Abstract

The clinical appearance of aortic dissection is characterized by the sudden, acute chest or abdominal pain, accompanied by coldness in the limbs and sweating-like symptoms of shock. Absent pulse or asymmetric pulse was observed in some patients. If the feeding arteries of the specific organs are located in the false lumen, this may lead to sudden loss of blood supply to the tissue e.g. spinal cord, resulting in cord damage. In the previous reports, approximately 20% of the individuals with aortic dissection might have neurological deficit resulting from insufficiency of blood supply. Most of the patients had suffered from severe chest or abdominal pain with sudden onset. Here we report a case with progressive neurological impairment because of long-term insufficient blood supply to the spinal cord. It is probably due to a painless aortic dissection. The patient was a 66-year-old male who presented with paraparesis. On examination, strength was 5/5 in both upper extremities and 3-4/5 in both lower extremities. Pricking sensation was relatively retarded below the sixth thoracic vertebra on both sides. Fine-touch sensation was limited below the ninth thoracic vertebra on the right side and below the eleventh thoracic vertebra on the left side. Responses to vibration and joint position sense were well preserved. Deep tendon reflexes were increased in his legs. He had voluntary anal contraction and preserved anal and bulbocavernous reflexes. MRI revealed dissection of the descending aorta from T4 to T10 levels with thrombus present in the false lumen, and the thoracic cord was marked atrophy, especially from T6 to T8 levels. To the best of our knowledge, no such case had been reported so far.

Language

English

First Page

251

Last Page

258

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