Successful treatment of delayed onset paraplegia after suprarenal abdominal aortic aneurysm repair.

Abstract

PARAPLEGIA is a well-recognized complication of thoracic aortic aneurysm (TAA) repair, but rarely occurs after abdominal aortic aneurysm (AAA) repair. 1,2 In most reported cases of postoperative paraplegia, it is difficult to identify the exact time of onset for the event, the factors that may have contributed to the development of spinal cord ischemia, or whether therapeutic interventions were effective. In the case described in this article, the delayed onset of paraplegia in the postoperative period after repair of a suprarenal AAA temporally followed an episode of hypotension, suggesting that the neurologic deficit was caused by hypoperfusion. Acute diagnosis and interventions directed to increase spinal cord perfusion by increasing arterial pressure and decreasing lumbar cerebrospinal fluid (CSF) pressure were immediately effective in reversing paraplegia, and led subsequently to full neurologic recovery.