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Spinal cord infarction during physical exertion due to polycythemia vera and aortoiliac occlusive disease: A case report.
- Source :
-
Medicine [Medicine (Baltimore)] 2018 Aug; Vol. 97 (35), pp. e12181. - Publication Year :
- 2018
-
Abstract
- Rationale: Spinal cord infarction is rarely caused by hypercoagulable states. Polycythemia vera (PV) is a myeloproliferative neoplasm that can contribute to thrombotic events due to increased blood viscosity. We report a case of spinal cord infarction due to extensive aortic thrombosis caused by PV.<br />Patient Concerns: A 56-year-old man presented with acute paraplegia and urinary retention during heavy physical exertion.<br />Diagnoses: Imaging studies revealed spinal cord infarction at the T9 to T12 levels and aortoiliac occlusive disease. PV was diagnosed during workup for elevated hemoglobin level INTERVENTIONS:: The patient received intravenous hydration and anticoagulation for spinal cord infarction. PV was managed with phlebotomy and hydroxyurea. Courses of inpatient and outpatient rehabilitation programs were also given.<br />Outcomes: The patient became urinary catheter-free 5 months after disease onset, and was able to walk with walker. The American Spinal Injury Association Impairment scale also improved from C at diagnosis to D during last follow-up.<br />Lessons: Etiologic workup is important for patients with spinal cord infarction to direct specific treatment strategies. Physical exertion may act as a trigger for infarction in patients at risk for thrombotic events, and monitoring of neurologic status during and after periods of exercise is warranted.
- Subjects :
- Aorta physiopathology
Aortic Diseases physiopathology
Arterial Occlusive Diseases physiopathology
Humans
Male
Middle Aged
Polycythemia Vera physiopathology
Aortic Diseases complications
Arterial Occlusive Diseases complications
Iliac Artery physiopathology
Infarction etiology
Physical Exertion physiology
Polycythemia Vera complications
Spinal Cord blood supply
Subjects
Details
- Language :
- English
- ISSN :
- 1536-5964
- Volume :
- 97
- Issue :
- 35
- Database :
- MEDLINE
- Journal :
- Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 30170466
- Full Text :
- https://doi.org/10.1097/MD.0000000000012181