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
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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 2021 Jan 23 ];16:402-403
Available from: https://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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| 2 | Yuh WT, Marsh EE 3 rd , Wang AK, Russell JW, Chiang F, Koci TM, et al. MR imaging of spinal cord and vertebral body infarction. AJNR Am J Neuroradiol 1992;13:145-54. |
| 3 | Masson C, Pruvo JP, Meder JF, Cordonnier C, Touzé E, De La Sayette V, et al. Spinal cord infarction: Clinical and magnetic resonance imaging findings and short term outcome. J Neurol Neurosurg Psychiatry 2004;75:1431-5. |
| 4 | Olearchyk AS. Saddle embolism of the aorta with sudden paraplegia. Can J Surg 2004;47:472-3. |
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