Overbeek, Remco 
ORCID: 0000-0002-4046-0234, Behrens, Amelie, Zopfs, David ORCID: 0000-0001-9978-7453, Mylonas, Spyridon ORCID: 0000-0002-9875-4614, Dorweiler, Bernhard ORCID: 0000-0002-8262-8381, Dusse, Fabian ORCID: 0000-0001-7762-6966, Böttiger, Bernd W. ORCID: 0000-0001-8000-8931 and Stoll, Sandra Emily ORCID: 0000-0002-4803-1362
(2024).
Weaning failure due to isolated residual diaphragmatic paralysis after cervical spinal cord ischemia following aortic surgery- a case report.
BMC Anesthesiology, 24 (1).
pp. 1-6.
Springer Nature.
ISSN 1471-2253
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Abstract
[Artikel-Nr.: 241] AnästhBackground: Bilateral diaphragmatic dysfunction can lead to dyspnea and recurrent respiratory failure. In rare cases, it may result from high cervical spinal cord ischemia (SCI) due to anterior spinal artery syndrome (ASAS). We present a case of a patient experiencing persistent isolated diaphragmatic paralysis after SCI at level C3/C4 following thoracic endovascular aortic repair (TEVAR) for Kommerell’s diverticulum. This is, to our knowledge, the first documented instance of a patient fully recovering from tetraplegia due to SCI while still exhibiting ongoing bilateral diaphragmatic paralysis. Case presentation: The patient, a 67-year-old male, presented to the Vascular Surgery Department for surgical treatment of symptomatic Kommerell’s diverticulum in an aberrant right subclavian artery. After successful surgery in two stages, the patient presented with respiratory insufficiency and flaccid tetraparesis consistent with anterior spinal artery syndrome with maintained sensibility of all extremities. A computerized tomography scan (CT) revealed a high-grade origin stenosis of the left vertebral artery, which was treated by angioplasty and balloon-expandable stenting. Consecutively, the tetraparesis immediately resolved, but weaning remained unsuccessful requiring tracheostomy. Abdominal ultrasound revealed a residual bilateral diaphragmatic paralysis. A repeated magnetic resonance imaging (MRI) 14 days after vertebral artery angioplasty confirmed SCI at level C3/C4. The patient was transferred to a pulmonary clinic with weaning center for further recovery. Conclusions: This novel case highlights the need to consider diaphragmatic paralysis due to SCI as a cause of respiratory failure in patients following aortic surgery. Diaphragmatic paralysis may remain as an isolated residual in these patients.
| Item Type: | Article |
| Creators: | Creators Email ORCID ORCID Put Code Behrens, Amelie UNSPECIFIED UNSPECIFIED UNSPECIFIED |
| URN: | urn:nbn:de:hbz:38-815752 |
| Identification Number: | 10.1186/s12871-024-02626-2 |
| Journal or Publication Title: | BMC Anesthesiology |
| Volume: | 24 |
| Number: | 1 |
| Page Range: | pp. 1-6 |
| Number of Pages: | 6 |
| Date: | 17 July 2024 |
| Publisher: | Springer Nature |
| ISSN: | 1471-2253 |
| Language: | English |
| Faculty: | Faculty of Medicine |
| Divisions: | Faculty of Medicine > Anästhesiologie und Operative Intensivmedizin > Klinik für Anästhesiologie und Operative Intensivmedizin Faculty of Medicine > Chirurgie > Klinik und Poliklinik für Gefäßchirurgie Faculty of Medicine > Radiologische Diagnostik > Institut und Poliklinik für Radiologische Diagnostik |
| Subjects: | Medical sciences Medicine |
| Uncontrolled Keywords: | Keywords Language Weaning failure ; Spinal ischemia ; Diaphragmatic paralysis English |
| ['eprint_fieldname_oa_funders' not defined]: | Publikationsfonds UzK |
| Refereed: | Yes |
| URI: | http://kups.ub.uni-koeln.de/id/eprint/81575 |
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