• Diseases in aorta are recognized as a widely seen contributor of spontaneous spinal cord ischaemia, represented by rupturing of thoracic aortic aneurysm, arterial occlusion by aortic intima separated from endothelial wall in aortic dissection, and aortic coarctation. (wikipedia.org)
  • Aortic disease causing ischemia (e.g., dissection, thrombosed aneurysm). (tomwademd.net)
  • [ 4 ] Nonetheless, ongoing studies are still trying to identify which patients with thoracic aortic dissection can benefit from TEVAR. (medscape.com)
  • Patients with complicated dissections, including cases of malperfusion (where a blood supply is impeded by flaps of aortic tissue caused by the dissection), appear to benefit from TEVAR to seal the site of dissection and reappose aortic wall layers. (medscape.com)
  • To address this question, a prospective, randomized clinical trial has been completed in Europe, the INSTEAD XL trial (INvestigation of STEnt grafts in patients with type B aortic dissection), which initially at 1 year did not show a mortality benefit. (medscape.com)
  • An aortic dissection and polyarteritis nodosa can be responsible for a spinal cord infarction. (medicinelearners.com)
  • Aortic dissection is the surging of blood through a tear in the aortic intima with separation of the intima and media and creation of a false lumen (channel). (msdmanuals.com)
  • Symptoms and signs include abrupt onset of tearing chest or back pain, and dissection may result in aortic regurgitation and compromised circulation in branch arteries. (msdmanuals.com)
  • Surgical repair of the aorta and placement of a synthetic graft are needed for ascending aortic dissection and for certain descending aortic dissections. (msdmanuals.com)
  • Clinical and pathologic findings of aortic dissection at autopsy: Review of 336 cases over nearly 6 decades. (msdmanuals.com)
  • Only among the EVAR patients, aortic related death occurred in 1 patient(5.6%), which was acute type A aortic dissection. (or.jp)
  • The angiography revealed a complete occlusion of the right coronary artery with intraluminar dissection and the ultrasound a severe malfunction of the right ventricle. (hippokratia.gr)
  • Thoracic endovascular aortic repair (TEVAR) was carried out to introduce a stent graft in order to treat thoracoabdominal aortic aneurysm, a condition of enlarged aorta with weakened vascular wall, as well as traumas and atherosclerosis. (wikipedia.org)
  • This essay sets out to discuss the care of one such patient, following surgery to repair an abdominal aortic aneurysm. (nursinganswers.net)
  • The care of a patient following surgical abdominal aortic aneurysm repair follows the principles of general postoperative surgical care, along with specific interventions, monitoring and support that are a consequence of the condition and the nature of the surgery. (nursinganswers.net)
  • He was referred to the local hospital for tests, which eventually led to a diagnosis of abominal aortic aneurysm. (nursinganswers.net)
  • Abdominal Aortic Aneurysm. (nursinganswers.net)
  • Abdominal Aortic Aneurysm (AAA) is a fairly common condition (the 14th leading cause of death in the US (Birkmeyer and Upchurch, 2007). (nursinganswers.net)
  • mean age 73.867.8 years, range 64-86) with degenerative infrarenal abdominal aortic aneurysm underwent EVAR with bifurcated stent-grafts and fibrin glue injection into the aneurysm sac at the conclusion of the endovascular procedure. (slideshare.net)
  • J Endovasc Ther 2007;14:176-183 Key words: abdominal aortic aneurysm, endovascular repair, stent-graft, type II endoleak, fibrin glue, sac embolization ¤ ¤ With an increasing demand for less invasive procedures, endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms (AAA) has emerged as a therapeutic alterna- tive to conventional surgery, leading to new complications and, consequently, to the de- velopment of specific techniques for their resolution. (slideshare.net)
  • A 4.2 cm-sized saccular thoracic aortic aneurysm (arrow) involving the aortic arch in initial computed tomography (CT) angiography (A) and intra-op angiography (B). Initial CT angiography showed 5.6 cm sized infrarenal abdominal aorta (C). Both pathologies were present in the three-dimensional reconstructive image (D). (vsijournal.org)
  • Objective:The availability of endovascular aneurysm repair(EVAR)has gradually increased the number of patients undergoing surgical treatment for ruptured abdominal aortic aneurysm(rAAA). (or.jp)
  • So now we have complete occlusion of the aneurysm with one coil and one flow diverter, and that jet that we're seeing here is no longer present. (neurosurgicalatlas.com)
  • Here, we are in a followup angiogram at the end of the case, showing again, excellent reconstruction of the vessel, complete occlusion of the aneurysm. (neurosurgicalatlas.com)
  • Spinal stenosis, ankylosing spondylitis. (tomwademd.net)
  • CT scan with contrast may detect bony abnormalities of the spinal canal (e.g., spinal stenosis), but is less sensitive for soft tissue disorders. (tomwademd.net)
  • Health Status after Transcatheter vs. Surgical Aortic Valve Replacement in Low-Risk Patients with Aortic Stenosis. (shda.org.au)
  • This prospective study was conducted alongside the PARTNER 3 trial (patients with severe aortic stenosis, at low surgical risk, 1:1 randomisation to either SAVR or TAVR). (shda.org.au)
  • Aortic Stenosis and Cardiac Amyloidosis. (shda.org.au)
  • This review discusses the clinical overlap, diagnosis, and management of cardiac amyloidosis (CA) and aortic stenosis (AS). (shda.org.au)
  • Early Surgery or Conservative Care for Asymptomatic Aortic Stenosis. (shda.org.au)
  • The American Association for the Surgery of Trauma's Aortic Occlusion for Resuscitation in Trauma and Acute Care Surgery (AORTA) registry recently compared the effectiveness of REBOA to open aortic occlusion (AO) in 114 patients across 8 trauma centers. (openanesthesia.org)
  • A basic knowledge of the signs and symptoms of acute spinal cord dysfunction are required in order to perform a relevant history and physical examination. (medscape.com)
  • These include acute transverse myelitis, spinal cord compression, and various demyelinating disorders. (medicinelearners.com)
  • Spinal ischemia underlies 6% of acute myelopathies [1]. (fortunejournals.com)
  • In the recently published case report by Haynes et al, intraarticular thrombolysis with tissue plasminogen activator (t-PA) in combination with verapamil and an antiplatelet agent (Eptifibatide) was performed for acute occlusion of the anterior spinal artery in a 52-year-old patient. (fortunejournals.com)
  • Our objective is to present a case of fatal acute occlusion of the right coronary artery after blunt thoracic trauma due to vehicle accident and conduct a brief review of the current literature. (hippokratia.gr)
  • A 58-year-old sustained chest trauma after a vehicle accident, complicated by acute occlusion of the right coronary artery. (hippokratia.gr)
  • Acute occlusion of the right coronary artery is a rare complication of blunt chest trauma. (hippokratia.gr)
  • Here we characterized the effect of intraspinal grafting of clinical grade human fetal spinal cord-derived neural stem cells (HSSC) on the recovery of neurological function in a rat model of acute lumbar (L3) compression injury. (biomedcentral.com)
  • Peri-acute intraspinal grafting of HSSC can represent an effective therapy which ameliorates motor and sensory deficits after traumatic spinal cord injury. (biomedcentral.com)
  • Occlusive vascular lesions affecting the spinal cord (spinal stroke) are diagnostic challenges. (medscape.com)
  • Spinal vascular involvement associated with vasculitis should also be considered as a cause. (medicinelearners.com)
  • A spinal cord infarction is an emergency and is a complication of various vascular diseases such as aortic aneurysms, arteriosclerosis or others. (medicinelearners.com)
  • Spinal ischemia in traumatized patients is rarely described, and when it occurs, it is usually associated with direct trauma to the spine and consecutive vascular injury. (fortunejournals.com)
  • More common causes are aneurysms of the aorta or ischemia after aortic surgery, compression of vascular structures by tumors, thrombosis or embolism and arterio-venous malformations. (fortunejournals.com)
  • Treatment of vascular myelopathy or spinal ischemia primarily involves improving spinal perfusion. (fortunejournals.com)
  • To date, no case has been described in the literature in which traumatized patients developed vascular myelopathy with a time delay without the presence of direct spinal trauma or direct vertebral vascular injury. (fortunejournals.com)
  • Three groups of vascular malformations dominate: medullary arteriovenous malformations (AVM), peri-arterial arteriovenous fistulas (AVF) and spinal meningeal FAF. (medical-actu.com)
  • The preclinical work focuses on animal models of myocardial ischemia-reperfusion injury, which is an experimental model for STEMI, as well as ex-vivo models of myocardial ischemia. (gu.se)
  • Yet, we couldn´t find any reported case of a trauma patient, that describes a late onset complete paraplegia of the lower limbs caused by spinal chord ischaemia without a spinal (chord) injury. (fortunejournals.com)
  • Althoughdamage of the heart vessels is a possible complication of blunt thoracic trauma, occlusion of the right coronary artery is rare and demands high level of suspicion by the emergency physicians. (hippokratia.gr)
  • Intraspinal grafting of human neural stem cells represents a promising approach to promote recovery of function after spinal trauma. (biomedcentral.com)
  • Extensive experimental and clinical data show that the mechanisms leading to a clinically-defined loss of neurological function after spinal trauma can in general be considered in two categories. (biomedcentral.com)
  • We report two cases of simultaneous endovascular aortic repair (EVAR) and thoracic endovascular aortic repair (TEVAR) for AAA and TAA. (vsijournal.org)
  • Whereas arterial occlusion in the spinal region quickly becomes symptomatic by neurological deficits, venous outflow obstruction may be clinically unnoticed for much longer and usually manifests as a slowly progressive neurological deficit. (fortunejournals.com)
  • Pattern of arterial supply to spinal cord and (left) territories of the anterior and posterior spinal arteries. (medscape.com)
  • The posterior spinal arteries are smaller paired arteries lying just medial to the dorsal roots. (medscape.com)
  • The aim of this paper was to identify and characterize all the segmental radiculomedullary arteries (RMAs) that supply the thoracic and lumbar spinal cord. (thejns.org)
  • Under local anesthesia and light sedation, it determines the anterior and posterior spinal feeder arteries by selective catheterization of the cervical, intercostal, lumbar and sacral arteries, knowing that an initial global study by aortic opacification (or bilateral retrograde humeral for the cervical region) can simplify exploration. (medical-actu.com)
  • A MAV has dilated arteries and spinal veins. (medical-actu.com)
  • Most often at high flow rates, they are multi-pediculated, almost always fed by ASA and one or more posterior spinal arteries. (medical-actu.com)
  • The Promus ELITE Everolimus-Eluting Platinum Chromium Coronary Stent System is indicated for improving luminal diameter in patients, including those with diabetes mellitus, with symptomatic heart disease or documented silent ischemia due to de novo lesions in native coronary arteries ≥2.25 mm to ≤4.00 mm in diameter in lesions ≤34 mm in length. (bostonscientific.com)
  • Abdominal aortic aneurysms are those which are located below the diaphragmatic border, and account for 75% of aortic aneurysms (Irwin, 2007). (nursinganswers.net)
  • With the recent increase in imaging tests, coexisting abdominal aortic aneurysms (AAAs) and thoracic aortic aneurysms (TAAs) are being discovered accidentally. (vsijournal.org)
  • As imaging tests are common during medical check-ups, coexisting thoracic aortic aneurysms (TAAs) and abdominal aortic aneurysms (AAAs) are often discovered incidentally. (vsijournal.org)
  • For example, antiplatelet and corticosteroids might be used to reduce the risk of blood clots in ischaemic spinal stroke patients, while rapid surgical decompression is applied to minimize neurological injuries in haemorrhagic spinal stroke patients instead. (wikipedia.org)
  • Myelopathy is a clinical diagnosis with localization of the neurological findings to the spinal cord, rather than the brain or the peripheral nervous system, and then to a particular segment of the spinal cord. (bvsalud.org)
  • Embolism, meningeal inflammation at spinal cord, global ischaemia and abusing nicotinic drugs are also identified to factors. (wikipedia.org)
  • Introduction: These studies were designed to determine whether PJ34, a novel Poly-ADP Ribose Polymerase Inhibitor, modulates expression of markers of stress and inflammation in the spinal cord following ischemia/ reperfusion(TAR). (elsevierpure.com)
  • Brain ischemia-reperfusion (IR) triggers a complex series of biochemical events including inflammation. (biomedcentral.com)
  • Cerebral ischemia-reperfusion (IR) triggers lipid peroxidation and inflammation, which exacerbate injury. (biomedcentral.com)
  • In ischemia, the p65 subunit is recognized to play an important role in regulation of inflammation [ 13 ]. (biomedcentral.com)
  • Ischemia/reperfusion (I/R) injury of the spinal cord is a dynamic process that frequently occurs during a variety of clinical situations such as thoracoabdominal aortic surgery or spinal cord injury [ 1 ]. (biomedcentral.com)
  • Abrupt onset of pain at the back or neck marks the location of ischaemia or hemorrhage at the beginning, which radiates as the damage intensifies. (wikipedia.org)
  • 1-3 It offers an alternative to resuscitative thoracotomy for clamping of the descending aortic to gain distal hemorrhage control. (openanesthesia.org)
  • Fortunately, such diagnosis is generally obvious: hemorrhage, pneumothorax, and spinal shock are easily diagnosed by the experienced clinician. (medicosecuador.com)
  • Myelopathy can be the result of primary intrinsic disorders of the spinal cord or from secondary conditions, which result in extrinsic compression of the spinal cord. (bvsalud.org)
  • Signs and symptoms are related to the portion of spinal cord affected, and appear below the level of lesion. (wikipedia.org)
  • Evaluating for a sensory level using a pin to detect pain sensation is more sensitive to detect a spinal level originating from a lesion in the spinothalamic tract. (emcrit.org)
  • Motor weakness may be used to evaluate the level of a spinal lesion that involves the corticospinal tract. (emcrit.org)
  • Thus, a central spinal cord lesion may cause neurologic deficits in a descending order. (emcrit.org)
  • Spinal cord lesion in the cervical or thoracic cord (especially a central cord lesion). (tomwademd.net)
  • Patients may spend years for rehabilitation after the spinal cord stroke. (wikipedia.org)
  • Patients with a male gender, younger age, lower body mass index, hypertension, diabetes mellitus, renal insufficiency and chronic obstructive pulmonary disease are predisposed to higher risks of severe spinal cord stroke. (wikipedia.org)
  • Patients with partial cord involvement may fail to display a sensory level. (emcrit.org)
  • A few case reports have described the metastasis of primary spinal cord tumors, and in most cases, patients were younger than 30 years of age. (bvsalud.org)
  • In 1994, Dake et al first reported the use of thoracic "stent-grafts" for the treatment of descending thoracic aortic aneurysms in patients who were believed to be at excessive risk for conventional open surgery. (medscape.com)
  • Importantly, a small percentage of patients who were undergoing TEVAR did not have their aneurysms entirely excluded from the aortic circulation at 1- and 2-year follow-up. (medscape.com)
  • Dake et al and investigators in Europe later showed TEVAR could be performed from a technical standpoint in patients with descending thoracic aortic dissections (patients with tears in the wall of their aortas). (medscape.com)
  • Type II, the most common form occurring in 5% to 17% of patients treated in clinical trials,1 arises from retrograde flow from the aortic side branches with their multiple feeding and draining vessels. (slideshare.net)
  • Of the patients in this series, there was only one patient death and none of the patients developed spinal cord ischemia. (dicardiology.com)
  • Both patients were successfully discharged without spinal cord ischemia. (vsijournal.org)
  • Results:About half of 17 patients(48.6%)were assigned to open repair and as many as 14 of them(82.4%)were excluded from the indication of endovascular treatment due to anatomical unsuitability, which included an extremely short proximal neck, severe aortic elongation and access route problems. (or.jp)
  • Notably, these responses are most apparent with more proximal zone I occlusion vs. zone III occlusion. (openanesthesia.org)
  • In the discussion following the presentation, Joseph Bavaria, M.D. , co-director, transcatheter valve program and director, thoracic aortic surgery program at Penn Medicine, noted that these timely findings were likely to affect national policy actions governing TAVR implementation in the United States. (dicardiology.com)
  • CA may be present in up to 15% of those with AS and has been associated with higher rates of heart failure, increased mortality, and treatment futility of surgical aortic valve replacement. (shda.org.au)
  • The first step towards diagnosis and therapy is recognizing that the patient has some sort of spinal cord pathology. (emcrit.org)
  • Case Description: We present an illustrative case of a 47-year-old female with metastatic lesions to the lumbosacral vertebrae years after the initial diagnosis of an intradural, intramedullary spinal cord tumor (IMSCT). (bvsalud.org)
  • The segmental RMAs supplying the thoracic and lumbar spinal cord can be unilateral, bilateral, or multiple. (thejns.org)
  • In central spinal cord syndrome, impairment of motor function in the upper body is considerably more severe than that of lower body, which is related to hyperextension of corticospinal tracts and spinocerebellar tract in cervical spinal cord, accompanied by dysfunction in urinary bladder and sensational loss at a varying degree. (wikipedia.org)
  • Lhermitte's sign (an electric-shock sensation elicited by neck flexion that runs down the spine and sometimes into the limbs) suggests involvement of the posterior columns of the cervical spinal cord. (emcrit.org)
  • however, the metastasis of primary spinal cord tumors to other regions in the body is an infrequent occurrence. (bvsalud.org)
  • Various pathological conditions, including surgical treatments, traumatic injuries, embolism, malformations and tumors, result in severe changes in the arterial blood supply to the spinal cord [ 1 ]. (intechopen.com)
  • The reduced blood flow to anterior and posterior radicular artery could trigger spinal stroke. (wikipedia.org)
  • The anterior spinal artery is a single long anastomotic channel that lies at the mouth of the anterior central sulcus and supplies the circulation to the anterior two thirds of the spinal cord, shown below. (medscape.com)
  • The largest anterior medullary artery, the great anterior medullary artery of Adamkiewicz, which is susceptible to occlusion with neurologic deficit, is located at the lumbar enlargement, usually at L2 on the left side (but may be at any point from T8 to L2). (medscape.com)
  • Multiple AKAs or additional RMAs supplying a single anterior spinal artery are common and should be considered when dealing with the spinal cord at the thoracolumbar level. (thejns.org)
  • It should be borne in mind that certain segments of the spinal cord are particularly susceptible to ischemia due to the sometimes low collateral supply to the anterior spinal artery. (medicinelearners.com)
  • Arteriosclerosis or an embolism can restrict the blood supply to the anterior (belly) located anterior spinal artery and the posterior (back) located spinal artery. (medicinelearners.com)
  • Computed tomography (CT) angiography showed 4.2 cm sized saccular TAA involving the aortic arch just distal to the left subclavian artery (LSA) and 5.6 cm sized AAA in the infrarenal region. (vsijournal.org)
  • Its resolution must be sufficient to detect a dorsal anterior spinal artery (ASA) of 300 μm caliber. (medical-actu.com)
  • The internal carotid artery (ICA) embryologically develops from the third primitive aortic arch. (medscape.com)
  • University of Florida/Shands Hospital in Gainesville, Florida, experience with open repair and Thoracic EndoVascular Aortic Repair (TEVAR) repair of thoracic aortic disease with a shift toward TEVAR. (medscape.com)
  • Therefore, a sensory level to light touch may be absent unless both of these are involved (e.g., a complete injury that involves all spinal cord tracts). (emcrit.org)
  • The present study was undertaken to study the effects of exogenous H2S on ischemia/reperfusion (I/R) injury of spinal cord and the underlying mechanisms. (biomedcentral.com)
  • The effects of exogenous H2S on I/R injury were examined by using assessment of hind motor function, spinal cord infarct zone by Triphenyltetrazolium chloride (TTC) staining. (biomedcentral.com)
  • Compared to I/R injury groups, H 2 S pretreatment had reduced spinal cord infarct zone, improved hind motor function in rats. (biomedcentral.com)
  • In rat model of I/R injury, pretreatment of pre-miR-30c or 3-MA (an inhibitor for autophagy) can abrogated spinal cord protective effect of H2S. (biomedcentral.com)
  • However, the protective effect of H2S on I/R injury of spinal cord has not been described. (biomedcentral.com)
  • Thus, we attempt to investigated the possible regulation role of H2S on spinal cord I/R injury in vitro or in vivo. (biomedcentral.com)
  • Although no evidence for miR-30c in spinal cord I/R injury, it has been proved to be a neural protector by targeting brain derived neurotrophic factoras well as neurotrophin signaling and axon guidance [ 10 ]. (biomedcentral.com)
  • Autophagy, a regulated process of degradation and recycling of cellular constituents, can participated in organelle turnover and the bioenergetic management of starvation of spinal cord injury [ 13 ]. (biomedcentral.com)
  • Several animal models exist to examine physiological and functional changes after the spinal cord injury with aim to explain knowledge about the spinal cord injury in human. (intechopen.com)
  • This chapter compares the arterial spinal cord blood supply of the frequently used species (pig, dog, cat, rabbit and rat) in experimental spinal cord injury and in human. (intechopen.com)
  • Spinal cord injury is associated with sustainable disability and results in loss of bladder, respiratory, cardiac, or sexual functions, and in varying degree of paralysis [ 2 ]. (intechopen.com)
  • There is usually primary spinal cord injury (SCI) that occurs within minutes of the original insult. (medscape.com)
  • It can be classified into two types, ischaemia and haemorrhage, in which the former accounts for 86% of all cases, a pattern similar to cerebral stroke. (wikipedia.org)
  • Emerging data implicate both 5-LOX and FLAP in the disease process of cerebral ischemia [ 6 ]. (biomedcentral.com)
  • These symptoms are based on a lack of or insufficient blood flow, which means that the spinal cord can no longer transmit signals from the brain. (medicinelearners.com)
  • Spinal epidural abscess. (tomwademd.net)
  • Lumbar puncture is initially contraindicated , since this could exacerbate a spinal epidural abscess or epidural hematoma. (tomwademd.net)
  • Less common causes of neurogenic shock include spinal anesthesia, transverse myelitis, Guillain-Barré syndrome , and autonomic nervous system toxins. (medscape.com)
  • The prognosis of spinal ischemia depends on the severity of the neurologic deficit that presents at the beginning [5]. (fortunejournals.com)
  • The evolution is made of partially regressive thrusts: spinal meningeal haemorrhage or hematomyelia. (medical-actu.com)
  • Reduction in myocardial contractility results in decreased cardiac output, hypotension, systemic vasoconstriction, and cardiac ischemia. (medscape.com)
  • In this post, I link to and excerpt the section on Cauda Equina Sydrome from Dr. Josh Farkas 's outstanding Internet Book of Critical Care 's [Link is to the TOC] chapter Spinal Cord , May 14, 2022. (tomwademd.net)
  • Temporary paresis in limbs may occur days before the onset of spinal ischaemic stroke, though the relationship remains unclear. (wikipedia.org)
  • Fibrocartilaginous emboli are described in up to 5.5% of cases for unexplained and sudden onset spinal ischemia [2]. (fortunejournals.com)
  • The Control Group underwent only aortic cross-clamping (n=6). (scielo.org)
  • Although deliberate hypotension during surgery may potentially cause organ ischaemia, in particular of the myocardium and cerebrum, it is widely used as an adjuvant. (annals.edu.sg)
  • Thrombosis/occlusion of the inferior vena cava causing enlargement of the epidural venous plexus. (tomwademd.net)
  • Aortic surgeries contribute to many iatrogenic spinal cord ischaemia, although its percentage is much lower than that of spontaneous type. (wikipedia.org)