Dafne Braga Diamante Leiderman1, Nelson Wolosker2, Marcos Vieira de Melo Oliveira3, Heitor Andrei Miranda de Carvalho4, Felipe Trajano de Freitas Barão5, Antonio Eduardo Zerati6, Nelson De Luccia7, Pedro Puech-Leão7. 1. Research Fellow in Vascular and Endovascular Surgery, Hospital Israelita Albert Einstein, São Paulo, Brazil. Electronic address: dah.diamante@gmail.com. 2. Associated Professor of the Discipline of Vascular Surgery, Hospital das Clínicas da Faculdade de Medicina, University of São Paulo, and Vascular and Endovascular Surgery Full Professor From Faculdade De Medicina Albert Einstein, São Paulo, Brazil. 3. Resident Physician of the Discipline of Vascular Surgery, Hospital das Clínicas da Faculdade de Medicina, University of São Paulo, São Paulo, Brazil. 4. Resident Physician of the Discipline of General Surgery, Hospital das Clínicas da Faculdade de Medicina, University of São Paulo, São Paulo, Brazil. 5. Attending Physician of the Emergency Service of the Discipline of Vascular Surgery, Hospital das Clínicas da Faculdade de Medicina, University of São Paulo, São Paulo, Brazil. 6. Attending Physician from the Cancer Institute, Hospital das Clínicas da Faculdade de Medicina, University of São Paulo, São Paulo, Brazil. 7. Full Professor of the Discipline of Vascular Surgery, Hospital das Clínicas da Faculdade de Medicina, University of São Paulo, São Paulo, Brazil.
Abstract
BACKGROUND: Transient paraplegia of the lower limbs is a rare condition and, when has a vascular etiology, is usually associated with thromboembolic events, aortic dissection, aortic aneurysms, or as a complication of the surgical correction of those diseases. There is no case reported of acute paraplegia caused by a segmental thrombotic subocclusion of the descending thoracic aorta. CASE REPORT: We report a not yet described clinical situation of a young patient (51 years) admitted to the emergency care department for treatment of systemic arterial hypertension of difficult control with 4 antihypertensive medication classes. At the intensive care unit for treatment with intravenous antihypertensive medication, the patient evolved with acute paraplegia and a segmental thrombotic subocclusion of the descending thoracic aorta was diagnosed. He was submitted to endovascular treatment with total recovery of the deficits. CONCLUSIONS: The previously normal descending thoracic aorta may be a site of segmental thrombosis and may lead to paraplegia. Early endovascular treatment can reverse this type of situation.
BACKGROUND: Transient paraplegia of the lower limbs is a rare condition and, when has a vascular etiology, is usually associated with thromboembolic events, aortic dissection, aortic aneurysms, or as a complication of the surgical correction of those diseases. There is no case reported of acute paraplegia caused by a segmental thrombotic subocclusion of the descending thoracic aorta. CASE REPORT: We report a not yet described clinical situation of a young patient (51 years) admitted to the emergency care department for treatment of systemic arterial hypertension of difficult control with 4 antihypertensive medication classes. At the intensive care unit for treatment with intravenous antihypertensive medication, the patient evolved with acute paraplegia and a segmental thrombotic subocclusion of the descending thoracic aorta was diagnosed. He was submitted to endovascular treatment with total recovery of the deficits. CONCLUSIONS: The previously normal descending thoracic aorta may be a site of segmental thrombosis and may lead to paraplegia. Early endovascular treatment can reverse this type of situation.