 |
| About Bioline | All Journals | Testimonials | Membership | News |
|
||||||
|
||||||
Neurology India, Vol. 57, No. 4, July-August, 2009, pp. 519-520 Neuroimage Aortic aneurysm presenting as conus-cauda syndrome Nilesh Anil Nadkarni, Sudheer Ramattu Yousef, Kamlesh Arjundas Jagiasi, Satish V. Khadilkar Department of Neurology, Grant Medical College, Sir J. J. Hospital, Mumbai, India Correspondence Address: Dr. Nilesh Nadkarni, Department of Neurology, Grant Medical College, Sir J. J. Hospital, Mumbai, India.drnileshnadu@gmail.com Date of Acceptance: 02-Jul-2009 Code Number: ni09157 PMID: 19770573 DOI: 10.4103/0028-3886.55580 A 65-year-old male developed retention of urine and constipation followed by subacute progressive weakness in both lower limbs. He had trauma to his back in childhood, when a wall of his house had collapsed on him without causing any deficit. On examination, he had gibbus from D11 to L2 vertebrae [Figure - 1]. Sensorimotor loss affecting L1 to S1 segments on either side, but more prominent in the L4-S1 distribution, was present. A clinical diagnosis of conus-cauda syndrome was made. MRI of dorso-lumbar spine showed a saccular aneurysm arising from posterior wall of thoraco-abdominal aorta from D11-L2 level [Figure - 2]a and b. There was calcification of the aneurysmal wall and its lumen contained a large eccentric lamellated thrombus. The aneurysm extended into the spinal canal by destroying D12 and L1 vertebral bodies and compressed the conus medullaris [Figure - 2]b. On CT aortography, the aneurysm was 6.8 × 6.5 × 5.8 cm 3 in dimensions [Figure - 3]a and b. The patient was nonhypertensive. His serum venereal disease research laboratory (VDRL) test was negative and he had no features suggesting disorders of collagen formation. Cause of the aneurysm could not be ascertained. Conus-cauda lesion is a rare complication of aortic aneurysm. A case of transient paraparesis as complication of an acute abdominal aortic aneurysm rupture, presumably due to occlusion of blood flow to conus medullaris, has been described. [1] Some cases have resulted as complications of open as also endovascular aneurysmorraphy. [2] This case highlights an unusual cause of conus cauda syndrome. Remission of paraparesis following aneurysmorraphy and spinal column repair can occur. [3] However, our patient did not opt for it. Acknowledgment We acknowledge the contribution of Radiology Department, Sir J. J. Hospital, to this case. References
Copyright 2009 - Neurology India The following images related to this document are available:Photo images[ni09157f2.jpg] [ni09157f3.jpg] [ni09157f1.jpg] |
| |||||||||
