| Popis: |
Spinal cord infarction is very rare condition and usually occurs in the thoracic region of the spine. The etiology is often unknown and patophysiology can be diverse. The stroke may occur while performing a surgical procedure, but it is also found in vascular diseases, for example dissecting aneurysms, vasculitis and vascular malformations.The authors present the case of a 62 year old woman admitted to the Neuroortopedics department due to metastasis of papillary renal carcinoma to the spine. During physical examination no neurological deficits were found. However magnetic resonance imaging revealed pathological tissue covering the left pedicle of the Th9 vertebra, penetrating the spinal canal, and compressing the spinal cord. The patient was qualified to the surgery and underwent tumor removal and transpedicular stabilization of the spine. The operation proceeded on schedule, without complications. After the operation the patient did not have any neurological deficits. In the first 24 hours post-surgery paresis of the lower limbs appeared, which rapidly deepened until the right limb was paralyzed. Due to the lack of improvement after administration of solumedrol, and suspicion of hematoma at the surgical site, the patient was qualified for reoperation. Intraoperatively there was no compression of the spinal cord, nonetheless, after being awaken from surgery, no active movements were found in the left lower limb. Magnetic resonance imaging was performed and revealed spinal cord infarction in its ventral part extending from Th9 to Th12.Even in procedures where no surgical complications appeared it should be noted that the rare risk of spinal cord infarction exists. |
