Laura van Zeggeren, MD, Evert J. Waasdorp, MD, Bart H

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Presentation transcript:

Painless transient paraparesis as the solitary manifestation of aortic dissection Laura van Zeggeren, MD, Evert J. Waasdorp, MD, Bart H. van de Worp, MD, PhD, Susanne T. Meijer, MD, Frans L. Moll, MD, PhD, Gert J. de Borst, MD, PhD Journal of Vascular Surgery Volume 54, Issue 5, Pages 1481-1484 (November 2011) DOI: 10.1016/j.jvs.2011.05.007 Copyright © 2011 Society for Vascular Surgery Terms and Conditions

Fig 1 Computed tomography angiography (CTA) of the thorax and abdomen at admission (upper images) reveals a penetrating ulcer of the proximal descending aorta and a dissection with thrombotic false lumen reaching below the level of the celiac trunk (arrow). A standard control CTA at 8-months follow-up (right images) still shows the penetrating ulcer at the site of entry at the aortic arch. Measurement in a three-dimensional fashion shows a slight decrease of the ulcer in both diameter and volume. There is distinct absorption of the thrombotic false lumen, also visible at celiac trunk level. Journal of Vascular Surgery 2011 54, 1481-1484DOI: (10.1016/j.jvs.2011.05.007) Copyright © 2011 Society for Vascular Surgery Terms and Conditions

Fig 2 Reconstruction of computed tomography angiography (CTA) showing the relationship between the penetrating aortic ulcer (arrow), the dissection, and the left subclavian artery (right image). At thoracic level, there is flow of contrast visible in the otherwise thrombotic false lumen (left image, arrowhead). Journal of Vascular Surgery 2011 54, 1481-1484DOI: (10.1016/j.jvs.2011.05.007) Copyright © 2011 Society for Vascular Surgery Terms and Conditions

Fig 3 Magnetic resonance imaging (MRI) scan of the thoracic spinal column shows focal increased signal intensity of the anterior thoracic spinal cord on the T2-weighted images particularly on the right side (arrow). This is compatible with ischemia in the area supplied by the anterior spinal artery. There is a clear dissection of the aorta (arrowhead). Journal of Vascular Surgery 2011 54, 1481-1484DOI: (10.1016/j.jvs.2011.05.007) Copyright © 2011 Society for Vascular Surgery Terms and Conditions