Acute Aortic Dissection Presenting as Bilateral Lower Extremity Paralysis: A Case Report

Hughes, Kate; Seguin, Colin; Felton, B.; Hughes, Mary J.

doi:10.1016/j.jemermed.2016.06.017

Cited by 6 publications

(5 citation statements)

References 12 publications

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“…Very few cases have been reported in which an AD presents with acute lower extremity paraparesis as the major initial complaint [8][9][10][11]. Our patient surely experienced acute spinal cord ischemia due to the injury of his thoracic aorta compromising blood flow to his spinal cord.…”

Section: Discussionmentioning

confidence: 91%

Sudden-Onset Paraplegia: A Unique Presentation of Acute Aortic Dissection (AD)

Campa¹,

Danboise²,

Cambron³

2023

Cureus

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Section: Discussionmentioning

confidence: 91%

Sudden-Onset Paraplegia: A Unique Presentation of Acute Aortic Dissection (AD)

Campa¹,

Danboise²,

Cambron³

2023

Cureus

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“…Possible accompanying symptoms are chest discomfort, abdominal pain, nausea/vomiting, and dyspnoea [ 9 , 166 – 204 ]. To confirm the diagnosis, imaging studies, such as computed tomography angiography (CTA), are used [ 167 , 170 , 189 , 194 , 205 – 208 ].…”

Section: Resultsmentioning

confidence: 99%

“…To confirm the diagnosis, imaging studies, such as computed tomography angiography (CTA), are used [ 167 , 170 , 189 , 194 , 205 – 208 ].…”

Section: Resultsmentioning

confidence: 99%

Extravertebral low back pain: a scoping review

Kunow,

Freyer Martins Pereira,

Chenot

2024

BMC Musculoskelet Disord

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Background Low back pain (LBP) is one of the most common reasons for consultation in general practice. Currently, LBP is categorised into specific and non-specific causes. However, extravertebral causes, such as abdominal aortic aneurysm or pancreatitis, are not being considered. Methods A systematic literature search was performed across MEDLINE, Embase, and the Cochrane library, complemented by a handsearch. Studies conducted between 1 January 2001 and 31 December 2020, where LBP was the main symptom, were included. Results The literature search identified 6040 studies, from which duplicates were removed, leaving 4105 studies for title and abstract screening. Subsequently, 265 publications were selected for inclusion, with an additional 197 publications identified through the handsearch. The majority of the studies were case reports and case series, predominantly originating from specialised care settings. A clear distinction between vertebral or rare causes of LBP was not always possible. A range of diseases were identified as potential extravertebral causes of LBP, encompassing gynaecological, urological, vascular, systemic, and gastrointestinal diseases. Notably, guidelines exhibited inconsistencies in addressing extravertebral causes. Discussion Prior to this review, there has been no systematic investigation into extravertebral causes of LBP. Although these causes are rare, the absence of robust and reliable epidemiological data hinders a comprehensive understanding, as well as the lack of standardised protocols, which contributes to a lack of accurate description of indicative symptoms. While there are certain disease-specific characteristics, such as non-mechanical or cyclical LBP, and atypical accompanying symptoms like fever, abdominal pain, or leg swelling, that may suggest extravertebral causes, it is important to recognise that these features are not universally present in every patient. Conclusion The differential diagnosis of extravertebral LBP is extensive with relatively low prevalence rates dependent on the clinical setting. Clinicians should maintain a high index of suspicion for extravertebral aetiologies, especially in patients presenting with atypical accompanying symptoms.

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“…A detailed assessment should include cardiovascular, neurological and abdominal examination due to the spectrum of its clinical presentation. Chest X-ray is obtained, but in high-risk patients’ absence of findings does not exclude the presence of disease and should not delay cardiac imaging 13 14. Contemporary practice to diagnose aortic dissection usually relies on the presence of true and false lumens on CT angiography especially in the emergency setting.…”

Section: Discussionmentioning

confidence: 99%

Paraplegia and acute aortic dissection: a diagnostic challenge for physicians in the emergency situation

Memon¹,

Aijaz

Memon

2019

BMJ Case Rep

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Acute aortic dissection presenting neurological symptoms is rare and entails significant diagnostic challenges. We present a case of 45-year-old woman with a medical history of essential hypertension and smoking, admitted with lobar pneumonia. During her inpatient treatment, she developed severe back pain and numbness below the level of the umbilicus. Due to her presenting symptoms considered differential diagnoses were paravertebral abscess and acute stroke. CT scan of the head did not reveal any ischaemic changes. Further investigation with MRI (with and without contrast) raised concerns for possible aortic dissection. CT angiography of thorax, abdomen and pelvis displayed extensive aortic dissection extending from aortic root to left iliac artery limiting flow to right carotid artery causing stenosis. The patient was diagnosed with Stanford type A aortic dissection. The patient was referred to the cardiothoracic surgery team for surgical repair. The patient made a good recovery after a prolonged course of hospitalisation, followed by cardiac rehabilitation and physical therapy.

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Acute Aortic Dissection Presenting as Bilateral Lower Extremity Paralysis: A Case Report

Cited by 6 publications

References 12 publications

Sudden-Onset Paraplegia: A Unique Presentation of Acute Aortic Dissection (AD)

Sudden-Onset Paraplegia: A Unique Presentation of Acute Aortic Dissection (AD)

Extravertebral low back pain: a scoping review

Paraplegia and acute aortic dissection: a diagnostic challenge for physicians in the emergency situation

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