Cheng-Ta Hsieha, b, Tzu-Tsao Chungb, Ming-Ying Liub
a Department of Neurosurgery, Sijhih Cathay General Hospital, New Taipei, Taiwan
b Department of Neurological Surgery, Tri-Service General Hospital and National Defense Medical Center, Taipei, TaiwanCheng-Ta Hsieha, b, Tzu-Tsao Chungb, Ming-Ying Liub
Abstract
Aortic dissection is a cardiovascular emergency, and the management remains a challenge for physicians because of the abrupt symptoms and rapid process. Acute neurological complications caused by descending aortic dissection, especially monoplegia, are rarely manifested. Herein, we present a 24-year-old man with Type B aortic dissection with acute onset of abdominal pain, accompanied by weakness and numbness only in the right lower extremity. After injection of contrast medium, computed tomography of the thorax and abdomen confirmed a diagnosis of Type B aortic dissection with the false lumen from the suprarenal descending aorta to the right common iliac artery. The monoplegia and paresthesia in the right lower extremity may have resulted from occlusion of the right common iliac artery because of the intimal flap. The detailed physical examination with absent pulsation of the right dorsalis pedis artery and right femoral artery, isolated low blood pressure and low motor neuron dysfunction of the right lower extremity, and abdominal/chest computed tomography were the key points for the correct diagnosis in our patient.
Keywords
Aortic dissection; Monoplegia; Paresthesia
