초록접수 현황
| 19F-232 | 포스터 발표 |
Acute Intramural Hematoma Complicated with Spinal Cord Ischemia and Intracerebral Hemorrhage Simultaneously
Kyo Seon Lee¹, Jae Beom Jeon¹, Cho Hee Lee¹, Eunchong Kim¹, Seok Kim², Do Wan Kim¹, Yochun Jung¹, In Seok Jeong¹, Sang Yun Song², Kook Joo Na², Byung Hee Ahn¹, Sang Gi Oh¹
¹Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Chonnam National University College of Medicine, Gwangju, Republic of Korea, ²Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hwasun Hospital, Chonnam National University College of Medicine, Jeollanam-do, Republic of Korea
Purpose : Spinal cord ischemia associated with aortic intramural hematoma is very rare. Furthermore, any case of spinal cord ischemia with intracerebral hemorrhage have not been reported.
Methods : A 56-year-old male with chest pain and back pain was transferred to our hospital for further evaluation and management of acute intramural hematoma of aorta. Chest and abdomen computed tomography (CT) revealed a diffuse intramural hematoma involving the ascending aorta to the infrarenal abdominal aorta. The patient was treated on intravenous drips of labetalol to decrease arterial blood pressure and heart rate. The next day, the patient complained of increasing bilateral lower extremity numbness and weakness. Brain magnetic resonance imaging (MRI) revealed acute hemorrhage of right pons and right parietal sulci (subarachnoid hemorrhage). Spine MRI showed increasing signal intensity of the spinal cord below T9 which was suspicious of the spinal cord ischemia. The patient was closely observed and the operation could not be performed until intracranial hemorrhage was absorbed. Follow-up chest CT revealed the increasing size of ulceration of proximal descending thoracic aorta and thickness of mural thrombus on the ascending aorta. Ascending aorta and total arch replacement was performed at the 18th hospital day.
Results : The patient was recovered except paraplegia.
Conclusion : Spinal cord ischemia complicated from intramural hemotoma is very rare. Early recognition of that is important. Cerebrospinal fluid drainage may be one of the strategies for acute aortic syndrome-induced spinal cord injury.
Methods : A 56-year-old male with chest pain and back pain was transferred to our hospital for further evaluation and management of acute intramural hematoma of aorta. Chest and abdomen computed tomography (CT) revealed a diffuse intramural hematoma involving the ascending aorta to the infrarenal abdominal aorta. The patient was treated on intravenous drips of labetalol to decrease arterial blood pressure and heart rate. The next day, the patient complained of increasing bilateral lower extremity numbness and weakness. Brain magnetic resonance imaging (MRI) revealed acute hemorrhage of right pons and right parietal sulci (subarachnoid hemorrhage). Spine MRI showed increasing signal intensity of the spinal cord below T9 which was suspicious of the spinal cord ischemia. The patient was closely observed and the operation could not be performed until intracranial hemorrhage was absorbed. Follow-up chest CT revealed the increasing size of ulceration of proximal descending thoracic aorta and thickness of mural thrombus on the ascending aorta. Ascending aorta and total arch replacement was performed at the 18th hospital day.
Results : The patient was recovered except paraplegia.
Conclusion : Spinal cord ischemia complicated from intramural hemotoma is very rare. Early recognition of that is important. Cerebrospinal fluid drainage may be one of the strategies for acute aortic syndrome-induced spinal cord injury.
책임저자: Sang Gi Oh
Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Chonnam National University College of Medicine, Gwangju, Republic of Korea
발표자: Kyo Seon Lee, E-mail : waytogosun@gmail.com