Acute Aortic Occlusion with Acute Onset of Paraplegia and Severe Hyposthenia

Valeria Fiorini,Fabio Spinetti,Daniela Viola,Giuseppe Mercogliano,Ines Marano,Giuseppe Sarti,Mariavittoria Guerra,Marina Lugarà,Stefania Tamburrini

doi:10.31487/j.rdi.2020.02.03

Abstract

A 75-years-old man presented at our ED with acute onset of paraplegia and severe bilateral lower limb hyposthenia. The patient ‘s neurological assessment was negative except for lower limbs positive Mingazzini test. CT angiography detected a complete lack of opacification of the abdominal aorta immediately below the emergency of the inferior mesenteric artery, caused by a coarse thrombus in the left ventricle. We present a case of acute aortic and lumbar arteries thrombosis with paraplegia and no clear symptoms of acute limb ischemia, in which the motor deficit in the lower extremities was explained by anterior spinal cord syndrome secondary to acute occlusion of lumbar arteries.

Highlights

Acute aortic occlusion (AAO) is a rare and infrequent medical condition with high mortality rate
We present a case of acute aortic and lumbar arteries thrombosis with paraplegia and no clear symptoms of acute limb ischemia, in which the motor deficit in the lower extremities was explained by anterior spinal cord syndrome secondary to acute occlusion of lumbar arteries
We report a case of AOO with acute onset of paraplegia and severe hyposthenia

Summary

Background

Acute aortic occlusion (AAO) is a rare and infrequent medical condition with high mortality rate. Clinical symptoms depend on the level of the aortic occlusion and can be mistaken for stroke or similar neurological disease. It may appear under extremely various forms, from absolutely asymptomatic up to the most serious clinical presentations with severe pain and ischemia of the lower limbs, sometimes accompanied by paresthesia or paraplegia. Intravenous contrast enhanced Multidetector Computed Tomography (MDCT) is the imaging modality of choice for investigating aortic occlusion; MDCT identifies possible comorbidities that can influence clinical management and therapeutic choices. We report a case of AOO with acute onset of paraplegia and severe hyposthenia

Case Presentation

Discussion