RESUMO
A 77-year-old female with a history of osteoarthritis visited our clinic complaining of lower back pain, paresthesia in both legs, and voiding difficulty. Her pain and temperature sensations were diminished below the L1 dermatome, and proprioception was decreased in both feet. The findings of a routine laboratory workup, echocardiogram, and cerebrospinal fluid studies were normal. Spine magnetic resonance imaging revealed high T2-weighted signal intensities and diffusion restriction in the posterior conus medullaris. The patient was diagnosed and treated for posterior spinal artery infarction.
Assuntos
Idoso , Feminino , Humanos , Artérias , Líquido Cefalorraquidiano , Caramujo Conus , Difusão , Pé , Infarto , Perna (Membro) , Dor Lombar , Imageamento por Ressonância Magnética , Osteoartrite , Parestesia , Propriocepção , Sensação , Compressão da Medula Espinal , Isquemia do Cordão Espinal , Doenças Vasculares da Medula Espinal , Medula Espinal , Coluna VertebralRESUMO
No abstract available.
Assuntos
Artérias , Ataxia , Infarto , Doenças Vasculares da Medula EspinalRESUMO
Rupture of isolated posterior spinal artery (PSA) aneurysms is a rare cause of subarachnoid hemorrhage (SAH) that presents unique diagnostic challenges owing to a nuanced clinical presentation. Here, we report on the diagnosis and management of the first known case of an isolated PSA aneurysm in the context of leukocytoclastic vasculitis. A 53-year-old male presented to an outside institution with acute bilateral lower extremity paralysis 9 days after admission for recurrent cellulitis. Early magnetic resonance imaging was read as negative and repeat imaging 15 days after presentation revealed SAH and a compressive spinal subdural hematoma. Angiography identified a PSA aneurysm at T9, as well as other areas suspicious for inflammatory or post-hemorrhagic reactive changes. The patient underwent a multilevel laminectomy for clot evacuation and aneurysm resection to prevent future hemorrhage and to establish a diagnosis. The postoperative course was complicated by medical issues and led to the diagnosis of leukocytoclastic vasculitis that may have predisposed the patient to aneurysm development. Literature review reveals greater mortality for cervical lesions than thoracolumbar lesions and that the presence of meningitic symptoms portents better functional outcome than symptoms of cord compression. The outcome obtained in this case is consistent with outcomes reported in the literature.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Aneurisma , Angiografia , Artérias , Celulite (Flegmão) , Diagnóstico , Hematoma Subdural Espinal , Hemorragia , Laminectomia , Extremidade Inferior , Imageamento por Ressonância Magnética , Mortalidade , Paralisia , Ruptura , Doenças Vasculares da Medula Espinal , Hemorragia Subaracnóidea , Vasculite , Vasculite Leucocitoclástica CutâneaRESUMO
No abstract available.