Abstract
Patients with spinal cord injury experience changes in the cardiovascular system and a high morbidity associated with peripheral artery disease. We report a case of acute aortic occlusion in a patient with chronic paralysis due to spinal cord injury. A 65-year-old man with chronic paralysis due to spinal cord injury developed mottling of the right extremity. Because of the complete tetraplegia, the patient had no subjective symptoms. Computed tomography revealed occlusion of the infrarenal abdominal aorta. An emergency thromboembolectomy established adequate blood flow, and the postoperative course was uneventful. The loss of muscle mass might be an advantage in avoiding ischemia reperfusion syndrome. Early detection of acute aortic occlusion and immediate reperfusion are primarily important, but patients with chronic paralysis present a risk of delay in detection, diagnosis, and treatment of acute aortic occlusion because of motor or sensory deficits. Although rare, it is necessary to consider acute aortic occlusion in the case of acute limb ischemia in patients with chronic paralysis due to spinal cord injury.
Highlights
Spinal cord injury (SCI) changes the cardiovascular system
We report a case of Acute aortic occlusion (AAO) in a patient with chronic paralysis due to SCI
The patient was at risk for heatstroke due to infrequent water intake related to chronic paralysis
Summary
Spinal cord injury (SCI) changes the cardiovascular system. SCI causes significant vascular and autonomic dysfunctions, such as blood pressure abnormalities (orthostatic hypotension, autonomic dysreflexia) and rhythm disturbances (bradyarrhythmias, reduced heart rate variability) [1, 2]. Case presentation A 65-year-old man, who had complete tetraplegia after SCI to the cervical spine due to a fall at the age of 51 years, developed cyanosis of the right lower extremity and was immediately admitted to our hospital in summer He had no complaint because of the motor or Yamamoto et al Surgical Case Reports (2016) 2:121 sensory deficits below the neck. He was a former smoker with impaired glucose tolerance and chronic obstructive pulmonary disease (COPD) but did not have hypertension or hyperlipidemia On admission, his vital signs were as follows: temperature, 37.5 °C; heart rate, 84 bpm; and blood pressure, 172/104 mmHg. Physical examination revealed mottling of the right lower extremity and loss of the bilateral femoral pulses (Fig. 1).
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