ABSTRACT
Abstract We present a patient with unstable angina candidate for coronary artery bypass grafting. Saphenous vein graft was used in obtuse marginal and left internal mammary artery to left anterior descending artery properly. After surgery, the patient experienced flaccid paralysis of lower limb and impaired sensation of touch and warmth of knee and below. A computed tomography angiogram of lower limbs and thoracolumbar magnetic resonance imaging showed no abnormality. Based on the symptom, clinical diagnosis of anterior spinal artery syndrome was considered. The artery of Adamkiewicz is an important supplier to the anterior spinal artery. Internal thoracic mammary artery, used in coronary artery bypass grafting, is suspected as a collateral supplier of the artery of Adamkiewicz and has been accused for cause of spinal infarction.
Subject(s)
Humans , Male , Middle Aged , Paraplegia/etiology , Postoperative Complications/etiology , Coronary Artery Bypass/adverse effects , Anterior Spinal Artery Syndrome/etiology , Paraplegia/diagnostic imaging , Magnetic Resonance Imaging , Angiography , Fatal Outcome , Anterior Spinal Artery Syndrome/diagnostic imaging , Lower Extremity/diagnostic imaging , Mammary ArteriesABSTRACT
Justificativa e objetivos - Complicações neurológicas da anestesia subaracnóidea, apesar de raras, podem determinar seqüelas importantes. O objetivo deste estudo é apresentar estas complicações com a finalidade de esclarecer os fatores desencadeantes, o que facilita o diagnóstico das lesões. Conteúdo - Säo apresentadas as seguintes complicações: lesäo de nervo desencadeada pela agulha e cateter, cefaléia pós-punçäo, síndrome da artéria espinhal anterior, hematoma espinhal, meningite bacteriana, meningite asséptica, aracnoidite adesiva, síndrome da cauda eqüina e sintomas neurológicos transitórios. Conclusões - O conhecimento dos fatores desencadeantes de complicações neurológicas determinadas pela anestesia subaracnóidea pode prevenir as lesões, diagnosticar e tratar mais precocemente e, desse modo, mudar o prognóstico das mesmas