Annals of Indian Academy of Neurology
IMAGES IN NEUROLOGY
Year
: 2013  |  Volume : 16  |  Issue : 3  |  Page : 402--403

Aortic saddle embolism and paraplegia due to a large left ventricular thrombus


Boby Varkey Maramattom1, Sudheer Ramattu Yousef1, George Joseph2,  
1 Department of Neurology, Lourdes Hospital, Kochi, Kerala, India
2 Department of Radiology, Lourdes Hospital, Kochi, Kerala, India

Correspondence Address:
Boby Varkey Maramattom
Department of Neurology, Lourdes Hospital, Kochi - 682 006, Kerala
India




How to cite this article:
Maramattom BV, Yousef SR, Joseph G. Aortic saddle embolism and paraplegia due to a large left ventricular thrombus.Ann Indian Acad Neurol 2013;16:402-403


How to cite this URL:
Maramattom BV, Yousef SR, Joseph G. Aortic saddle embolism and paraplegia due to a large left ventricular thrombus. Ann Indian Acad Neurol [serial online] 2013 [cited 2019 Sep 18 ];16:402-403
Available from: http://www.annalsofian.org/text.asp?2013/16/3/402/116960


Full Text

A 52-year-old man presented with an acute excruciating back pain and paraplegia with the clammy and pulseless legs, grade 0/5 power, and a sensory level at T10. 8 h later magnetic resonance imaging (MRI) spine showed bilateral psoas muscle infarction with a normal spinal cord. Computed tomography (CT) angiogram showed a thrombotic occlusion of the infra-renal aorta and a large thrombus within the left ventricle [Figure 1]. 12 h later, he developed massive melena and expired. Spinal cord imaging may be normal in up to 14% of patients with spinal infarction in the early phase, [1] although, surrogate markers such as vertebral body infarction on T2-weighted MRI may be present. [2] Nevertheless, acute paraplegia accompanied by severe back and limb pain is highly suggestive of spinal infarction. [3] Saddle aortic embolism and paraplegia from embolism of a left ventricular clot is uncommon. [4] Psoas muscle infarction on MRI has not been described with an aortic thrombo-embolic occlusion.{Figure 1}

References

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