Anterior spinal artery syndrome with chronic traumatic aortic aneurysm

Monoparesis due to spinal cord infarction associated with thoracoabdominal aneurysm

We describe a case of acute monoparesis of a lower limb due to asymmetric spinal cord infarction in a patient with previously unrecognized thoracoabdominal aneurysm. The clinical course suggested that the likely reason for the spinal cord infarction was thromboembolism originating from the aneurysm's mural thrombi. This rare entity should be considered when managing patients with acute mono- or paraparesis who have a thoracoabdominal aneurysm with mural thrombi because interventions aimed at preventing further embolisms could be beneficial in these patients.

Anterior spinal artery syndrome in an adolescent with protein S deficiency

The diagnosis of anterior spinal artery syndrome can be made with high accuracy by thorough clinical examination in combination with typical magnetic resonance imaging findings. Sudden onset of tetra- or paraparesis and dissociated sensory loss with bladder dysfunction are the leading clinical signs. We discuss clinical and radiologic findings in an adolescent presenting with anterior spinal artery syndrome. The laboratory results showed a hereditary protein S deficiency.

Mycotic thoracic aortic aneurysm producing vertebral body destruction and paraplegia: case report

In the surgical treatment of an aortic aneurysm, disruption of the blood supply to the spinal cord, resulting in paraplegia and anaesthesia below the level of involvement, is a dreaded complication. Occasionally, when an aortic aneurysm compresses a major vessel that supplies the anterior spinal artery, spinal cord ischaemia and paraplegia can occur before surgery. In the case presented here, however, preoperative paraplegia appears to have resulted from direct spinal destruction by an infected aortic aneurysm that was originally diagnosed as a spinal abscess. The patient underwent operative repair, but her aorta was so friable that the sutures would not hold. Despite repeat surgery, her condition rapidly proved fatal. This case shows that, in patients with a suspected spinal abscess, computer tomographic scanning and angiography should be performed to confirm the diagnosis and to rule out other pathological conditions. An accurate pre-operative diagnosis will permit adequate operative planning and prevent catastrophic results.

Concomitant repair of a chronic traumatic aortic aneurysm with tracheal erosion

Tracheal erosion from a chronic false aneurysm secondary to trauma is unusual. Resection with graft interposition is the treatment of choice. This case report describes the additional use of an intrathoracic muscle flap necessitated by tracheal erosion and contamination.