The great radicular artery of Adamkiewicz in man. Demonstration of a possibility to predict its functional territory.

A women in her early sixties suffered from a malignant intramedullary astrocytoma. It had caused a nearly complete neurological deficit extending from the 12th thoracic segment downward. Since progressive tumour growth caused excruciating pain it was decided to remove the tumorous non-functional part of the spinal cord. As the great radicular artery was located in the region of the tumour it was feared that it might have to be sacrificed during surgery. In order to be informed as to its vascularization and the clinical consequence of interrupting it, an anaesthetic agent (Etomidate) was injected through this vessel. This resulted in a temporary increase in the neurological deficit by two dermatomes. Fortunately during surgery the Adamkiewicz artery was preserved. This intervention completely abolished the patient's complaints.