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Ischemic Affection of the Spinal Cord as a Result of the Blunt Thoracic Trauma – A Case Report


Authors: K. Šmejkal 1;  I. Žvák 1;  T. Holeček 2;  P. Habal 3;  P. Lochman 1
Authors place of work: Katedra válečné chirurgie, Fakulta vojenského zdravotnictví UO Hradec Králové vedoucí katedry: doc. MUDr. L. Klein, CSc. 1;  Chirurgická klinika FN a LF UK Hradec Králové, přednosta kliniky: doc. MUDr. A. Ferko, CSc. 2;  Kardiochirurgická klinika FN a LF UK Hradec Králové, přednosta kliniky: doc. MUDr. J. Harrer, Ph. D. 3
Published in the journal: Rozhl. Chir., 2008, roč. 87, č. 7, s. 344-346.
Category: Monothematic special - Original

Summary

Authors present the case of a patient who suffered the blunt thoracic trauma. In the clinical picture there dominated the paraplegia of both the lower extremities. Due to the weakened breathing on the right side the urgent thoracic drainage was performed. For circulation instability and amount of blood passing out of the drain an urgent thoracotomy was indicated even prior to the CT or MRI. During the operation bleeding from the Adamkiewicz’s artery was spotted and sanated. After the postoperative stabilization the CT and MRI investigations proved the spinal cord ischemia as a cause of the local damage.

Key words:
blunt thoracic trauma – Adamkiewicz’s artery – spinal cord ischemia


Zdroje

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3. Willis, B., Greiner, F., Orrison, W., et al. The incidence of vertebral artery injury after midcervical spine fracture or subluxation. Neurosurgery, 1994; 34: 435–442.

4. Fabian, T. C., Richardson, J. D., Croce, M. A., et al. Prospective Study of Blunt Aortic Injury: Multicenter Trial of the American Association for the Surgery of Trauma. J. Trauma, 1997; 42: 374–383.

5. Flores, J., Shiiya, N., Kunihara, T., et al. Risk of Spinal Cord Injury After Operations of Recurrent Aneurysm of the Descending aorta. Ann. Thorac. Surg., 2005; 79: 1245–1249.

6. von Oppel, U. D., Dunne, T. T., DeGreeot, M. K., et al. Spinal cord protection in the absence of collateral circulation: meta-analysis of mortality and paraplegia. J. Cardiac. Surg., 1994; 9: 685–691.

7. Lazorthes, G., Gouaze, A., Zadeh, J. O., et al. Arterial vascularization of the spinal cord: recent studies of the anastomotic substitution pathways. J. Neurosurg., 1971; 35: 253–262.

8. Rogers, F. B., Osier, T. M., Shackford, S. R., et al. Isolater Stab Wound to the Artery of Adamkiewicz: Case Report and Review of the Literature. J. Trauma, 1997; 43: 549–551.

Štítky
Surgery Orthopaedics Trauma surgery

Článok vyšiel v časopise

Perspectives in Surgery

Číslo 7

2008 Číslo 7
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