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CASE REPORT
Paraplegia and acute aortic dissection: a diagnostic challenge for physicians in the emergency situation
  1. Waqas Memon1,
  2. Zobia Aijaz2 and
  3. Rmaah Memon3
  1. 1 Department of Internal Medicine, Carle Foundation Hospital, Urbana, Illinois, USA
  2. 2 Dow University of Health Sciences, Karachi, Pakistan
  3. 3 UMKC School of Medicine, Kansas City, Missouri, USA
  1. Correspondence to Dr Waqas Memon, waqasm03{at}hotmail.com

Abstract

Acute aortic dissection presenting neurological symptoms is rare and entails significant diagnostic challenges. We present a case of 45-year-old woman with a medical history of essential hypertension and smoking, admitted with lobar pneumonia. During her inpatient treatment, she developed severe back pain and numbness below the level of the umbilicus. Due to her presenting symptoms considered differential diagnoses were paravertebral abscess and acute stroke. CT scan of the head did not reveal any ischaemic changes. Further investigation with MRI (with and without contrast) raised concerns for possible aortic dissection. CT angiography of thorax, abdomen and pelvis displayed extensive aortic dissection extending from aortic root to left iliac artery limiting flow to right carotid artery causing stenosis. The patient was diagnosed with Stanford type A aortic dissection. The patient was referred to the cardiothoracic surgery team for surgical repair. The patient made a good recovery after a prolonged course of hospitalisation, followed by cardiac rehabilitation and physical therapy.

  • resuscitation
  • adult intensive care
  • neurology
  • cardiovascular medicine
  • hypertension
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Footnotes

  • Contributors The conception of the topic and interpretation of previous research was done by WM and ZA. Case report design and clinical insight along with interpretation was done by WM, RM and ZA. Thorough research of previous case reports of similar nature was done by WM and ZA.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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