Brown-Séquard Syndrome after Thoracic Endovascular Aortic Repair for a Stanford Type B Aortic Dissection.
Adine J KlijnJennie HeidaDesiree H C BurgerJan M M HeyligersSjaak PouwelsPublished in: Vascular specialist international (2022)
We present a case of Brown-Séquard syndrome (BSS) after thoracic endovascular aortic repair (TEVAR) to treat Stanford type B aortic dissection. A 49-year-old male presented to the emergency department with acute tearing pain between the scapulae, connected to respiratory movements. Computed tomography showed Stanford type B aortic dissection from the left subclavian artery to the level of the 11th thoracic vertebra. Conservative treatment was initiated with intravenous antihypertensives. However, due to persistent pain and an increase in the aortic diameter with an intramural hematoma, TEVAR was performed. The patient developed symptoms suspicious of spinal cord ischemia postoperatively. A lesion limited to the left-sided spinal cord was observed on magnetic resonance imaging at the level of the 4th to 5th thoracic vertebra. BSS after TEVAR is a rare phenomenon with a fairly good prognosis, depending on the initial injury severity.
Keyphrases
- aortic dissection
- spinal cord
- neuropathic pain
- magnetic resonance imaging
- computed tomography
- emergency department
- spinal cord injury
- chronic pain
- case report
- pain management
- contrast enhanced
- positron emission tomography
- heart failure
- sleep quality
- coronary artery
- physical activity
- atrial fibrillation
- acute respiratory distress syndrome
- pet ct