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Case Reports
. 2022 Jun 30:38:12.
doi: 10.5758/vsi.220008.

Brown-Séquard Syndrome after Thoracic Endovascular Aortic Repair for a Stanford Type B Aortic Dissection

Adine J Klijn  1 , Jennie Heida  2 , Desiree H C Burger  1   3 , Jan M M Heyligers  3 , Sjaak Pouwels  1
Affiliations
Case Reports

Brown-Séquard Syndrome after Thoracic Endovascular Aortic Repair for a Stanford Type B Aortic Dissection

Adine J Klijn et al. Vasc Specialist Int. .

Abstract

We present a case of Brown-Séquard syndrome (BSS) after thoracic endovascular aortic repair (TEVAR) to treat Stanford type B aortic dissection. A 49-year-old male presented to the emergency department with acute tearing pain between the scapulae, connected to respiratory movements. Computed tomography showed Stanford type B aortic dissection from the left subclavian artery to the level of the 11th thoracic vertebra. Conservative treatment was initiated with intravenous antihypertensives. However, due to persistent pain and an increase in the aortic diameter with an intramural hematoma, TEVAR was performed. The patient developed symptoms suspicious of spinal cord ischemia postoperatively. A lesion limited to the left-sided spinal cord was observed on magnetic resonance imaging at the level of the 4th to 5th thoracic vertebra. BSS after TEVAR is a rare phenomenon with a fairly good prognosis, depending on the initial injury severity.

Keywords: Aortic dissection; Endovascular procedures; Spinal cord ischemia; Vascular surgery.

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Conflict of interest statement

CONFLICTS OF INTEREST

The authors have nothing to disclose.

Figures

Fig. 1
Fig. 1
Computed tomography showed a Stanford type B aortic dissection. The arrow indicates the entry tear.
Fig. 2
Fig. 2
Intraoperative and postoperative images after a successful thoracic endovascular aortic repair (arrow). (A) Intraoperative angiography. (B) Postoperative computed tomography scan.
Fig. 3
Fig. 3
Axial magnetic resonance imaging showed a left-sided lesion at the level of the 4th to 5th thoracic vertebra. The arrow points at the lesion, which is lighter than the right side, compatible with spinal cord ischemia.
See this image and copyright information in PMC

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