Cauda Equina Syndrome
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Studies from Ohio State University, Division of Vascular Surgery yield new data on thrombosis
2009 JUN 15 - (NewsRx.com) -- A new study, 'Acute cauda equina syndrome secondary to iliocaval thrombosis successfully treated with thrombolysis and pharmacomechanical thrombectomy,' is now available. In this recently published article, scientists in the United States conducted a study "To present two cases of lower extremity paraplegia associated with acute iliocaval thrombosis successfully treated with thrombolysis. A 36-year-old morbidly obese woman with a history of lower extremity deep venous thrombosis (DVT), pulmonary embolism (PE), and inferior vena cava (IVC) filter placement 4 years prior presented with back pain." "Imaging showed iliac vein engorgement consistent with thrombosis and common femoral vein DVT bilaterally. She was started on intravenous heparin but developed marked lower extremity weakness while anticoagulated. Given these progressive symptoms, systemic tissue plasminogen activator was administered, with subsequent improvement over 48 hours. At 6-month follow-up, she was living independently, with near normal strength and sensation in her lower extremities. While hospitalized following an assault, a 55-year-old man with a history of factor V Leiden, DVT/PE, and prior IVC filter developed marked left lower extremity swelling, which progressed to severe bilateral lower extremity edema and mottling, along with sensory and motor loss of the lower extremities. Lower extremity duplex confirmed extensive DVT extending from the level of the iliac veins down to the tibial vessels. He underwent successful pharmacomechanical thrombectomy. At 6 months, he was walking normally, with no residual neurological symptoms and no evidence of DVT. Acute cauda equina syndrome related to iliocaval thrombosis and epidural variceal engorgement presenting with complete paraplegia has not to our knowledge been reported," wrote M.R. Go and colleagues, Ohio State University, Division of Vascular Surgery. The researchers concluded: "Pharmacomechanical thrombectomy affords an opportunity to achieve complete iliocaval clearance in a single procedure and is well-suited to cases in which neural infarction is imminent." Go and colleagues published their study in the Journal of Endovascular Therapy (Acute cauda equina syndrome secondary to iliocaval thrombosis successfully treated with thrombolysis and pharmacomechanical thrombectomy. Journal of Endovascular Therapy, 2009;16(2):233-7). For more information, contact M.R. Go, The Ohio State University Medical Center, Division of Vascular Surgery, Columbus, Ohio USA.. Publisher contact information for the Journal of Endovascular Therapy is: Alliance Communications Group Division Allen Press, 810 East 10TH Street, Lawrence, KS 66044, USA. Keywords: United States, Columbus, Angiology, Back Pain Relief, Bariatrics, Cauda Equina Syndrome, Endovascular Therapy, Enzyme Research, Femoral Vein, Hematology, Heparin, Iliac Vein, Obesity, Paralysis, Paraplegia, Pharmaceuticals, Plasminogen, Polyradiculopathy, Pulmonary Embolism, Pulmonology, Surgery, Therapy, Thrombectomy, Thrombolysis, Thrombosis, Treatment, Vena Cava, Venous Thrombosis. This article was prepared by Pain & Central Nervous System Week editors from staff and other reports. Copyright 2009, Pain & Central Nervous System Week via NewsRx.com.
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