Incomplete Anterior Spinal Artery Syndrome Responsive to Intrathecal Baclofen.
abdominal aortic stenosis
anterior cord syndrome
anterior spinal artery syndrome
baclofen
endovascular repair of abdominal aneurysm
intrathecal
spasticity
Journal
Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737
Informations de publication
Date de publication:
Jun 2023
Jun 2023
Historique:
accepted:
12
06
2023
medline:
17
7
2023
pubmed:
17
7
2023
entrez:
17
7
2023
Statut:
epublish
Résumé
Anterior cord syndrome (ACS) occurs as a result of ischemia in the territory of the anterior spinal artery (ASA). Although spinal cord strokes are rare, the ASA is the most commonly affected vessel in the spinal cord. The typical presentation of an ASA stroke is paraparesis or paraplegia, bilateral loss of pain and temperature sensation, and fecal or urinary incontinence; the underlying neural structures responsible for these symptoms include the corticospinal tracts and anterior horns, anterolateral spinothalamic tracts, and lateral horns, respectively. ACS is a feared complication of aortic procedures and has been well-documented to occur during or after endovascular abdominal aortic aneurysm revascularization (EVAR). We report a case of incomplete or partial ACS presenting with delayed-onset spasticity and instability several months following EVAR, who was subsequently treated with intrathecal baclofen. We hypothesize that this patient's ischemia selectively damaged descending white matter tracts responsible for modulating the stretch receptor reflex, including damage to the corticospinal tract, which likely also impaired positional stability.
Identifiants
pubmed: 37456462
doi: 10.7759/cureus.40391
pmc: PMC10345232
doi:
Types de publication
Case Reports
Langues
eng
Pagination
e40391Informations de copyright
Copyright © 2023, Waack et al.
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
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