Unilateral Posterior Spinal Cord Ischemia Due to a Floating Aortic Thrombus: A Case Report
<i>Introduction</i>. Spinal cord ischemia (SCI) accounts for less than 1% of all strokes, and mostly affects the anterior cord. The ascending aorta (AA) is the rarest site of localization for aortic thrombi (5%). We report a singular case of posterior SCI due to a floating thrombus in th...
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MDPI AG
2023-09-01
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| Series: | Clinical and Translational Neuroscience |
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| Online Access: | https://www.mdpi.com/2514-183X/7/3/26 |
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| author | Fabrizio Giammello Anna Gardin Teresa Brizzi Carmela Casella Maria Carolina Fazio Karol Galletta Enricomaria Mormina Sergio Lucio Vinci Rosa Fortunata Musolino Paolino La Spina Antonio Toscano |
| author_facet | Fabrizio Giammello Anna Gardin Teresa Brizzi Carmela Casella Maria Carolina Fazio Karol Galletta Enricomaria Mormina Sergio Lucio Vinci Rosa Fortunata Musolino Paolino La Spina Antonio Toscano |
| author_sort | Fabrizio Giammello |
| collection | DOAJ |
| description | <i>Introduction</i>. Spinal cord ischemia (SCI) accounts for less than 1% of all strokes, and mostly affects the anterior cord. The ascending aorta (AA) is the rarest site of localization for aortic thrombi (5%). We report a singular case of posterior SCI due to a floating thrombus in the AA. <i>Case presentation.</i> A 75-year-old male with acute left hemiparesis and left tactile and proprioceptive sensory loss below the C5 dermatome (NIHSS 3) is presented. Spinal cord MRI showed a C4–C6 ischemic lesion, involving the left lateral posterior hemi-cord. CT angiography showed a 6 mm floating thrombus in the AA. According to cardiovascular surgeons, dual antiplatelet therapy and high-dose statin were started. After seven days, the patient was discharged with mild left distal hemiparesis and an unchanged sensory deficit. <i>Conclusions.</i> Posterior SCI is rarer than anterior ischemia and potentially unilateral. Its clinical presentation is mainly sensory with possible, but not systematic, weakness of the homolateral limbs. SCI is often caused by aortic pathologies in the elderly, but the incidence rate of non-aneurysmal aortic mural thrombus is about 0.45% and the AA represents a very rare location. In similar cases, conservative medical treatment is preferred despite the high-risk rates of embolic recurrences. |
| first_indexed | 2024-03-10T22:53:18Z |
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| institution | Directory Open Access Journal |
| issn | 2514-183X |
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| last_indexed | 2024-03-10T22:53:18Z |
| publishDate | 2023-09-01 |
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| series | Clinical and Translational Neuroscience |
| spelling | doaj.art-7de37f99f5af4966b426a9ff6435fbd62023-11-19T10:10:31ZengMDPI AGClinical and Translational Neuroscience2514-183X2023-09-01732610.3390/ctn7030026Unilateral Posterior Spinal Cord Ischemia Due to a Floating Aortic Thrombus: A Case ReportFabrizio Giammello0Anna Gardin1Teresa Brizzi2Carmela Casella3Maria Carolina Fazio4Karol Galletta5Enricomaria Mormina6Sergio Lucio Vinci7Rosa Fortunata Musolino8Paolino La Spina9Antonio Toscano10Stroke Unit, Department of Clinical and Experimental Medicine, University of Messina, 98124 Messina, ItalyStroke Unit, Department of Clinical and Experimental Medicine, University of Messina, 98124 Messina, ItalyStroke Unit, Department of Clinical and Experimental Medicine, University of Messina, 98124 Messina, ItalyStroke Unit, Department of Clinical and Experimental Medicine, University of Messina, 98124 Messina, ItalyStroke Unit, Department of Clinical and Experimental Medicine, University of Messina, 98124 Messina, ItalyNeuroradiology Unit, Department of Biomedical, Dental Science and Morphological and Functional Images, University of Messina, 98124 Messina, ItalyNeuroradiology Unit, Department of Biomedical, Dental Science and Morphological and Functional Images, University of Messina, 98124 Messina, ItalyNeuroradiology Unit, Department of Biomedical, Dental Science and Morphological and Functional Images, University of Messina, 98124 Messina, ItalyStroke Unit, Department of Clinical and Experimental Medicine, University of Messina, 98124 Messina, ItalyStroke Unit, Department of Clinical and Experimental Medicine, University of Messina, 98124 Messina, ItalyStroke Unit, Department of Clinical and Experimental Medicine, University of Messina, 98124 Messina, Italy<i>Introduction</i>. Spinal cord ischemia (SCI) accounts for less than 1% of all strokes, and mostly affects the anterior cord. The ascending aorta (AA) is the rarest site of localization for aortic thrombi (5%). We report a singular case of posterior SCI due to a floating thrombus in the AA. <i>Case presentation.</i> A 75-year-old male with acute left hemiparesis and left tactile and proprioceptive sensory loss below the C5 dermatome (NIHSS 3) is presented. Spinal cord MRI showed a C4–C6 ischemic lesion, involving the left lateral posterior hemi-cord. CT angiography showed a 6 mm floating thrombus in the AA. According to cardiovascular surgeons, dual antiplatelet therapy and high-dose statin were started. After seven days, the patient was discharged with mild left distal hemiparesis and an unchanged sensory deficit. <i>Conclusions.</i> Posterior SCI is rarer than anterior ischemia and potentially unilateral. Its clinical presentation is mainly sensory with possible, but not systematic, weakness of the homolateral limbs. SCI is often caused by aortic pathologies in the elderly, but the incidence rate of non-aneurysmal aortic mural thrombus is about 0.45% and the AA represents a very rare location. In similar cases, conservative medical treatment is preferred despite the high-risk rates of embolic recurrences.https://www.mdpi.com/2514-183X/7/3/26spinal cord ischemia case reportfree-floating thrombusaortic atherosclerosishemodynamic strokeposterior spinal artery occlusion |
| spellingShingle | Fabrizio Giammello Anna Gardin Teresa Brizzi Carmela Casella Maria Carolina Fazio Karol Galletta Enricomaria Mormina Sergio Lucio Vinci Rosa Fortunata Musolino Paolino La Spina Antonio Toscano Unilateral Posterior Spinal Cord Ischemia Due to a Floating Aortic Thrombus: A Case Report Clinical and Translational Neuroscience spinal cord ischemia case report free-floating thrombus aortic atherosclerosis hemodynamic stroke posterior spinal artery occlusion |
| title | Unilateral Posterior Spinal Cord Ischemia Due to a Floating Aortic Thrombus: A Case Report |
| title_full | Unilateral Posterior Spinal Cord Ischemia Due to a Floating Aortic Thrombus: A Case Report |
| title_fullStr | Unilateral Posterior Spinal Cord Ischemia Due to a Floating Aortic Thrombus: A Case Report |
| title_full_unstemmed | Unilateral Posterior Spinal Cord Ischemia Due to a Floating Aortic Thrombus: A Case Report |
| title_short | Unilateral Posterior Spinal Cord Ischemia Due to a Floating Aortic Thrombus: A Case Report |
| title_sort | unilateral posterior spinal cord ischemia due to a floating aortic thrombus a case report |
| topic | spinal cord ischemia case report free-floating thrombus aortic atherosclerosis hemodynamic stroke posterior spinal artery occlusion |
| url | https://www.mdpi.com/2514-183X/7/3/26 |
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