| Japanese |
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| Title | 対麻痺を併発した急性A型大動脈解離に対する緊急手術 |
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| Subtitle | 症例 |
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| Authors | 鈴木憲治, 石山雅邦, 石原茂樹 |
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| Authors(kana) | |
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| Organization | 群馬県済生会前橋病院心臓血管外科 |
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| Journal | 循環制御 |
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| Volume | 29 |
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| Number | 2 |
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| Page | 159-162 |
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| Year/Month | 2008/9 |
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| Article | 報告 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 「はじめに」急性A型大動脈解離において臓器虚血症状を伴うことがある. 脊髄虚血は頻度は稀であるが, 合併した際の予後は不良である. 今回我々は対麻痺症状を伴う急性A型大動脈解離症例に対し緊急手術を行い, 良好な結果を得た. 心筋症に対する加療中に発症した稀な経緯と, 対麻痺回復の稀な経過をたどった症例を報告する. 「症例」症例：40歳男性 既往歴：38歳時に肥大型心筋症, 高血圧を指摘された. 家族歴：特記事項なし. 現病歴：38歳時に労作時呼吸困難出現した(New York Heart Association classification(NYHA)II). 増悪傾向のため入院し内科的治療後に精査したところ, 心臓カテーテル検査にてdiffuse severe hypokinesis, 左室拡張末期圧17mmHg, 左室駆出率35%, であり, 肥大型心筋症に伴う低心機能と診断された. 以後は利尿剤, carvedilol, telmisartanによる内服治療を外来で継続した. 40歳時, 早朝突然の胸背部痛にて当院救急外来受診し, 大動脈解離の診断にて入院となった. このとき既に下肢の感覚異常および対麻痺を発症していた. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | paraplegia, aortic dissection, hypertrophic cardiomyopathy, left velltricular dysfunction, ascending aorta replacement |
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| English |
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| Title | Transient Paraplegia Following Acute Aortic Dissection |
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| Subtitle | |
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| Authors | Kenji Suzuki, Masakuni Ishiyama, Shigeki Ishihara |
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| Authors(kana) | |
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| Organization | Department of Cardiovascular Surgery, Saiseikai Maebashi Hospital |
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| Journal | Circulation Control |
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| Volume | 29 |
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| Number | 2 |
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| Page | 159-162 |
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| Year/Month | 2008/9 |
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| Article | Report |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | Presentation of aortic dissection with neurological manifestation is uncommon and the prognosis of this disease must be guarded. We here report a case of 40year-old man who underwent an emergency operation with ascending aorta replacement under the diagnosis of transient paraplegia with acute aortic dissection(type A). He had the history of hypertrophic cardiomyopathy with left ventricular dysfunction. It was most likely that our patient had ischemia to spinal cord following aortic dissection. On awakening from anesthesia, he was found to be flaccidity and hypersensitive of left lower extremity and dysuria. Nevertheless, he showed steady improvement with return of his neurological function and 83 days after the operation he walked from the hospital with little remaining neurological symptoms or signs. |
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| Practice | Basic medicine |
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| Keywords | paraplegia, aortic dissection, hypertrophic cardiomyopathy, left velltricular dysfunction, ascending aorta replacement |
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