Atraumatic ischaemic myelopathy

Kewalramani, L S; Katta, Rajani

doi:10.1038/sc.1981.67

Cited by 5 publications

(2 citation statements)

References 18 publications

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“…Of these two had a preoperative paraplegia and one was neurologically unimpaired. Six had dissecting aortic aneurysms (3,7,8,9,11,12). All but one were neurologically unimpaired before the surgery.…”

Section: Methodsmentioning

confidence: 99%

Ischaemic myelopathy following aortic surgery or traumatic laceration of the aorta

et al. 1998

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Paraplegia is one of the major complications following repair of aortic aneurysms or congenital malformations and from trauma of the aorta. In a series of 12 surviving patients we describe the clinical features as well as the evolution and pathophysiology of ischaemic lesions of the spinal cord. The clinical characteristics: loss of tendon re¯exes, preservation of light touch sensation and bladder function, and the special topography of pin prick impairment, suggest involvement of the central grey matter. This lesion of the grey matter is incomplete in most of the patients and tends to extend for 2 ± 10 segments. In some cases it can extend downward to the conus resulting in complete¯accid paraplegia. On follow-up we have observed limited improvement in most cases. No patient has recovered fully. Except in cases of traumatic laceration, where symptoms existed before surgery, paraplegia followed surgical repair in all other cases. Ischaemia can be related to the duration and the site of crossclamping of the aorta. Clamping above the left subclavian artery and/or a ligation of the intercostal arteries without previous visualisation of the spinal cord arteries can be dangerous. Other factors such as the phenomena of revascularisation and the presence of free radicals are discussed. These could explain delayed postischaemic spinal cord hypoperfusion.

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Section: Methodsmentioning

confidence: 99%

Ischaemic myelopathy following aortic surgery or traumatic laceration of the aorta

et al. 1998

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“…Only 3 cases in cluded an examination of posterior column function; in one case it was intact5 and in 2 it was abnormal. 6 We postulate a disturbance of a spinal artery in the thoracic region affecting the circulation of the left side of the spinal cord. The entire left half of the spinal cord, not just the anterior portion supplied by the anterior spinal artery, must have been involved to account for the References posterior column dysfunction present in this case.…”

Section: Discussionmentioning

confidence: 99%

Modified Brown-Séquard syndrome following coronary artery bypass graft: case report

1992

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A 75 year old man underwent a triple coronary artery bypass graft performed with intra-aortic balloon pump assistance. Left leg weakness developed on the first postoperative day, progressive worsening occurred over the next 2! weeks, finally culminating in a modified Brown-Sequard pattern of deficit. No etiology was found. Previous reports of spinal cord injury following coronary artery bypass graft are reviewed and the microcirculation of the spinal cord is discussed.

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Aortic dissection following coronary artery bypass surgery: Diagnosis by CT

Archer

Choyke

Zeman

et al. 1986

Cardiovasc Intervent Radiol

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We describe an unusual case of aortic dissection causing spinal cord infarction. The dissection arose from an intimal tear at the suture line of a coronary artery bypass graft. CT was used to diagnose the dissection and to demonstrate its extension to the aortoiliac bifurcation and innominate artery and its rupture into the left pleural cavity. The most common causes of intimal tears following cardiac bypass surgery are aortic cross-clamping, aortic cannulation, and injury during suturing of the graft to the aorta. An underlying disease of the aorta such as atherosclerosis, cystic medial necrosis, or aortitis is commonly present. CT is an accurate and safe means of detecting aortic dissections following cardiac surgery, and is also useful in assessing the extent of the dissection and identifying its rupture into the pleural or pericardial cavity.

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Atraumatic ischaemic myelopathy

Cited by 5 publications

References 18 publications

Ischaemic myelopathy following aortic surgery or traumatic laceration of the aorta

Ischaemic myelopathy following aortic surgery or traumatic laceration of the aorta

Modified Brown-Séquard syndrome following coronary artery bypass graft: case report

Aortic dissection following coronary artery bypass surgery: Diagnosis by CT

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