Adamkiewitz syndrome in Marfan syndrome and rehabilitation outcomes-3 cases and review of the literature

Abstract

Acute Spinal Cord Ischemia Syndrome (ASCIS) is rare but clinically significant. Aortic dissection (AD) is one reason for ischemia of the spinal cord. The artery of Adamkiewicz provides the major blood supply to the anterior thoracolumbar spinal cord, and injury to this artery can cause consequential neurologic damage.Three male patients applied to our rehabilitation clinic with paraplegia. All three had AD due to Marfan Syndrome and clinical findings due to Adamkiewitz artery ischemia. Although we later learned that one of the patients later died from a new ruptured aortic aneurysm, we achieved good motor gains in these rare cases with rehabilitation. Although paraplegia is rare as the initial symptom in AD, vascular etiology should not be forgotten in acute paraplegia. The prognosis of ASCIS is known to be poor, but a good and individualized rehabilitation program is required.