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J Thorac Cardiovasc Surg 2003;125:409-410
© 2003 The American Association for Thoracic Surgery

Brief Communications

Atypical paraplegia after aortic intramural hematoma

Naotaka Motoyoshi, MDa, Tsunehiro Komatsu, MDa, Yoshimasa Moizumi, MDa, Koichi Tabayashi, MDb Sendai, Japan

From the Department of Thoracic and Cardiovascular Surgery, Sendai City Medical Center,a and the Department of Cardiovascular Surgery, Graduate School of Medicine, Tohoku University,b Sendai, Japan.

Received for publication April 25, 2002. Accepted for publication June 26, 2002. Address for reprints: Naotaka Motoyoshi, MD, Department of Thoracic and Cardiovascular Surgery, Sendai City Medical Center, 22-1, Tsurugaya 5-choume, Miyagino-ward, Sendai-City 983-0824 Japan (E-mail: naotaka@openhp.or.jp).

The first 20% of the full text of this article appears below.

Aortic intramural hematoma (IMH) has previously been reported both at necropsy and in vivo and was recently described as a distinct entity. IMH appears to be characterized primarily by aortic wall hematoma without demonstrable intimal flap and occurs as a result of spontaneous rupture of the vasa vasorumGo 1 or intimal fracture of an atherosclerotic plaque, which allows blood propagation into the aortic media.Go 2

On the basis of its pathologic feature, mesenteric ischemia by means of branch occlusion is supposed to be complicated with IMH. However, few incidents of perfusion disorder after IMH have been reported, whereas 2.5% to 12.0% of aortic dissections are complicated.Go 3 We report a rare case of IMH resulting in ischemia of the spinal cord and the right iliopsoas muscle, representing atypical paraplegia.

Clinical summary

At 5 PM on February 1, 2002, a 46-year-old patient had sudden onset of chest pain. On admission, he was hypertensive (182/80 mm Hg), and extremity pulses were palpated normally. Electrocardiography revealed a normal sinus rhythm and no ST-T-segment change. . . . [Full Text of this Article]




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 J. Thorac. Cardiovasc. Surg.Home page
Y. Moizumi, T. Komatsu, N. Motoyoshi, and K. Tabayashi
Clinical features and long-term outcome of type A and type B intramural hematoma of the aorta
J. Thorac. Cardiovasc. Surg., February 1, 2004; 127(2): 421 - 427.
[Abstract] [Full Text] [PDF]


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