scholarly journals Posterior Circulation Intervention but Mind the Spinal Cord!

2021 ◽  
Vol 05 (03) ◽  
pp. 186-189
Author(s):  
Shahyan Mohsin Siddiqui ◽  
Chandrajit Prasad ◽  
Hima Pendharkar ◽  
Indira Devi Bhagavatula ◽  
Karthik Kulanthaivelu
Keyword(s):  
Spinal Cord ◽  
Rare Complication ◽  
Posterior Circulation ◽  
Uncontrolled Hypertension ◽  
Spinal Cord Infarction ◽  
Local Flow ◽  
Hemodynamic Compromise ◽  
Life Threatening ◽  
Posterior Circulation Aneurysms ◽  
Weighted Magnetic Resonance Imaging

AbstractSpinal cord infarction (SCI), a rare complication following endovascular treatment of posterior circulation aneurysms, is infrequently recognized in the periprocedural period. We illustrate the same with digital subtraction angiography and diffusion-weighted magnetic resonance imaging in this series of two cases. Categorically, the anterior spinal artery was patent, post-procedure, in both instances. Likely, guiding catheter-induced local flow alterations initiates the pathogenesis. A subsequent insufficiency of radiculomedullary artery (RMA) reinforcements is the probable mechanism leading to hemodynamic compromise. Our observations further reiterate that periprocedural antiplatelet therapy is conceivably ineffective in preventing SCI. Besides, advanced age and uncontrolled hypertension could potentially exacerbate the periprocedural RMA compromise. Due vigilance is required to recognize this rare and potentially life-threatening complication in posterior circulation neurovascular intervention.

scholarly journals Spinal Cord Infarction is an Unusual Complication of Intracranial Neuroendovascular Intervention

2013 ◽  
Vol 19 (4) ◽  
pp. 500-505 ◽  
Author(s):  
Noriaki Matsubara ◽  
Shigeru Miyachi ◽  
Takeshi Okamaoto ◽  
Takashi Izumi ◽  
Takumi Asai ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Coil Embolization ◽  
Cranial Nerve ◽  
Cervical Spinal Cord ◽  
Posterior Circulation ◽  
Spinal Cord Infarction ◽  
Unusual Complication ◽  
Flow Restriction ◽  
Catheter Technique ◽  
Endovascular Coil Embolization

Spinal cord infarction is an unusual complication of intracranial neuroendovascular intervention. The authors report on two cases involving spinal cord infarction after endovascular coil embolization for large basilar-tip aneurysms. Each aneurysm was sufficiently embolized by the stent/balloon combination-assisted technique or double catheter technique. However, postoperatively, patients presented neurological symptoms without cranial nerve manifestation. MRI revealed multiple infarctions at the cervical spinal cord. In both cases, larger-sized guiding catheters were used for an adjunctive technique. Therefore, guiding catheters had been wedged in the vertebral artery (VA). The wedge of the VA and flow restriction may have caused thromboemboli and/or hemodynamic insufficiency of the spinal branches from the VA (radiculomedullary artery), resulting in spinal cord infarction. Spinal cord infarction should be taken into consideration as a complication of endovascular intervention for lesions of the posterior circulation.

scholarly journals Anterior spinal cord syndrome as a rare complication of acute bacterial meningitis in an adult

2018 ◽  
pp. bcr-2018-226082 ◽  
Author(s):  
Kwang Sheng Ng ◽  
Sanihah Abdul Halim
Keyword(s):  
Spinal Cord ◽  
Bacterial Meningitis ◽  
Daily Living ◽  
Rare Complication ◽  
Central Nervous System Infection ◽  
Acute Bacterial Meningitis ◽  
Spinal Cord Infarction ◽  
Adequate Treatment ◽  
Systemic Complications ◽  
Spinal Cord Dysfunction

Acute bacterial meningitis is not an uncommon central nervous system infection. In severe cases, it can be associated with various neurological or systemic complications. However, acute spinal cord dysfunction rarely occurs. We report a case of bacterial meningitis complicated with spinal cord infarction despite adequate treatment with antibiotics and corticosteroid therapy. He had residual paraplegia and was fully dependent in the activity of daily living.

scholarly journals 106 Haemorrhagic spinal cord infarct – a rare complication of sympathomimetic amine toxicity

2019 ◽  
Vol 90 (e7) ◽  
pp. A34.3-A35
Author(s):  
Ellen L Wall ◽  
Jerome A Leow ◽  
Jonathan Ho ◽  
Yun T Hwang
Keyword(s):  
Spinal Cord ◽  
Vascular Malformations ◽  
Rare Complication ◽  
Acute Onset ◽  
Lower Limbs ◽  
Spinal Cord Infarction ◽  
Urine Drug Screen ◽  
Sympathomimetic Amines ◽  
Thoracic Level ◽  
Sympathomimetic Amine

IntroductionSympathomimetic amines are recreational substances, available illegally as amphetamine derivatives (eg, ‘ecstasy’ and ‘speed’). Ingestion can lead to significant medical complications such as hyperthermia, tachyarrhythmia, seizures and strokes, attributed to catecholamine surge and sympathetic overstimulation.MethodWe report an unusual case of sympathomimetic amine ingestion manifesting as hypertension followed by acute onset flaccid paralysis of lower limbs bilaterally and T11 level anaesthesia in a 64 year old woman secondary to haemorrhagic cord infarct.ResultsAn MRI spine showed features compatible with spinal cord infarction from thoracic level 6/7 to conus associated with cord haemorrhage. There was no evidence of vascular malformations on imaging and the screen for inflammatory myelitides was negative. A urine drug screen tested positive for sympathomimetic amines and the patient acknowledged ingesting a pill of ‘unknown identity’.ConclusionThis case highlights a previously unreported complication of recreational sympathomimetics associated with significant patient morbidity. Unfortunately, this woman failed to make significant improvements during admission with ongoing severe motor and sensory deficits of her lower limbs.

scholarly journals Spinal cord infarction in a 41-year-old male patient with COVID-19

2021 ◽  
pp. 197140092198892
Author(s):  
Mamdouh Eissa ◽  
Mohamed Abdelhady ◽  
Hosam Alqatami ◽  
Khaled Salem ◽  
Ahmed Own ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Severe Acute Respiratory Syndrome ◽  
Post Infection ◽  
Transverse Myelitis ◽  
Severe Infection ◽  
Neurological Complications ◽  
Posterior Circulation ◽  
Spinal Cord Infarction ◽  
Cytokine Storm ◽  
Artery Thrombosis

The severe acute respiratory syndrome coronavirus disease 2019 (COVID-19) pandemic, became rapidly recognised by variable phonotypic expressions that involve most major body organs. Neurological complications of severe acute respiratory syndrome coronavirus disease are increasingly encountered in patients with COVID-19 infection, more frequently in patients with severe infection, and develop as a consequence of the neurotropic potential of this virus, secondary cytokine storm and acquired syndrome of COVID-19 coagulopathy. Spinal cord involvement after COVID-19 more commonly includes infectious transverse myelitis, para and post infection myelopathy and, rarely, spinal cord ischaemia related to increased coagulopathy with thromboembolic consequences. We herein report a COVID-19-positive patient with increased coagulopathy and vertebral artery thrombosis leading to posterior circulation and subsequent spinal cord infarction.

Spinal cord infarction demonstrated by diffusion-weighted magnetic resonance imaging

2005 ◽  
Vol 12 (4) ◽  
pp. 466-468 ◽  
Author(s):  
Mizuya Shinoyama ◽  
Toshiyuki Takahashi ◽  
Hiroaki Shimizu ◽  
Teiji Tominaga ◽  
Michiyasu Suzuki
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Magnetic Resonance ◽  
Spinal Cord Infarction ◽  
Resonance Imaging ◽  
Diffusion Weighted ◽  
Weighted Magnetic Resonance Imaging

A Curious Case of Progressive Respiratory Failure Due to Anterior Spinal Cord Infarction in an Adolescent Boy: A Case Report and Review of the Literature

2021 ◽  
Author(s):  
Caroline Chinchilla Putzeys ◽  
Mansi Batra ◽  
Paul Maertens ◽  
Kamal Sharma
Keyword(s):  
Spinal Cord ◽  
Position Sense ◽  
Spinal Cord Infarction ◽  
Posterior Aspect ◽  
Fibrocartilaginous Embolism ◽  
Threatening Condition ◽  
Progressive Respiratory Failure ◽  
Life Threatening ◽  
Temperature Sensations ◽  
Magnetic Resonance Imaging Mri

AbstractClinical features of cervical spontaneous spinal cord infarctions (SSCIs) remain poorly described in the literature. The goal of this article is to improve recognition of cervical SSCI, a rare but life-threatening condition. We present a 15-year-old adolescent boy who developed neck pain with weakness and numbness in all four limbs half an hour after returning from a hike in the late afternoon. The next morning, he was brought to the emergency room due to persistent weakness, vomiting, and progressive respiratory distress. He was promptly intubated for airway protection. Pupils were 2 mm, sluggishly reactive, and all four extremities were flaccid. He was found to have anterior spinal cord syndrome. Light touch (brush) was normal down to the posterior aspect of shoulders. Cervical magnetic resonance imaging (MRI) showed increased T2/short-tau inversion recovery and decreased T1 signal of the anterior spinal cord from C3 to C7. Four days later, MRI of the spinal cord showed restricted diffusion of anterior spinal cord consistent with radicular artery territory infarction. The work-ups for infection, thrombosis, and cardioembolism were all negative. Three months later, he still had incomplete Brown-Séquard's syndrome, as position sense was preserved. There was in addition bilateral loss of pain and temperature sensations below the clavicles. MRI showed cervical myelomalacia most severe between C3 and C5. Furthermore, MRI showed changes in C3–C4 intervertebral disc, consistent with a fibrocartilaginous embolism via retrograde arterial route into the anterior spinal artery. This article demonstrates the importance of recognizing subtle clinical clues leading to cervical SSCI diagnosis.

Proximal deep venous thrombosis following PTA of the superficial femoral artery – an obligation to disclose a complication that is rarely taken into account

VASA ◽  
2006 ◽  
Vol 35 (1) ◽  
pp. 41-44 ◽  
Author(s):  
Klein-Weigel ◽  
Pillokat ◽  
Klemens ◽  
Köning ◽  
Wolbergs ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Rare Complication ◽  
Femoral Vein ◽  
Vein Thrombosis ◽  
Explicit Information ◽  
Life Threatening ◽  
Legal Consequences

We report two cases of femoral vein thrombosis after arterial PTA and subsequent pressure stasis. We discuss the legal consequences of these complications for information policies. Because venous thrombembolism following an arterial PTA might cause serious sequel or life threatening complications, there is a clear obligation for explicit information of the patients about this rare complication.

Alteraciones sistémicas y metabólicas producidas por lesión medular

2019 ◽  
Vol 1 (1) ◽  
pp. 59-75
Author(s):  
Gabriel Guízar Sahagún
Keyword(s):  
Spinal Cord ◽  
Daily Living ◽  
Autonomic Function ◽  
Clinical Presentation ◽  
Scientific Literature ◽  
International Standards ◽  
Therapeutic Approaches ◽  
Cord Injury ◽  
Life Threatening ◽  
The Impact

Besides the well-known loss of motor and sensory capabilities, people with spinal cord injury (SCI) experience a broad range of systemic and metabolic abnormalities including, among others, dysfunction of cardiovascular, respiratory, gastrointestinal, urinary, and endocrine systems. These alterations are a significant challenge for patients with SCI because such disorders severely interfere with their daily living and can be potentially life-threatening. Most of these disorders are associated with impairment of regulation of the autonomic nervous system, arising from disruption of connections between higher brain centers and the spinal cord caudal to the injured zone. Thus, the higher and more complete the lesion, the greater the autonomic dysfunction and the severity of complications.This article summarizes the medical scientific literature on key systemic and metabolic alterations derived of SCI. It provides information primarily focused on the pathophysiology and clinical presentation of these disorders, as well as some guides to prevent and alleviate such complications. Due to the impact of these alterations, this topic must be a priority and diffuse to those involved with the care of people with SCI, including the patient himself/herself. We consider that any collaborative effort should be supported, like the development of international standards, to evaluate autonomic function after SCI, as well as the development of novel therapeutic approaches.

Sign in / Sign up

Export Citation Format

Share Document