Acute Crit Care.  2018 Aug;33(3):187-190. 10.4266/acc.2016.00556.

Spinal Cord Infarction in a Patient Undergoing Veno-arterial Extracorporeal Membrane Oxygenation

• Shin B
• Cho YH
• Choi JH
• Yang JH

• KMID: 2436332
• DOI: http://doi.org/10.4266/acc.2016.00556

Abstract

Spinal cord infarction is an uncommon, but serious disorder characterized by severe motor impairment and bladder and bowel dysfunction. Spinal cord infarction is likely caused by hypoperfusion at the thoraco-lumbar spinal cord due to diverse reasons. An 81-year-old woman without motor or neurologic dysfunction presented with cardiogenic shock due to acute myocardial infarction. We performed veno-arterial extracorporeal membrane oxygenation (VA ECMO) to maintain adequate organ perfusion. Lower limb weakness was noted on day 1 of ECMO support. Although the symptom persisted, we could not carry out further evaluation because of her hemodynamic instability. After removal of ECMO, spinal magnetic resonance imaging was performed and showed a signal abnormality extending from the level of T5 to the conus medullaris. The patient underwent conservative management, but eventually experienced limb paralysis. Herein, we report a case of spinal cord infarction in a patient with myocardial infarction during VA ECMO support.

Keyword

extracorporeal membrane oxygenation; spinal cord infarction

MeSH Terms

Aged, 80 and over
Extracorporeal Membrane Oxygenation*
Extremities
Female
Hemodynamics
Humans
Infarction*
Lower Extremity
Magnetic Resonance Imaging
Myocardial Infarction
Neurologic Manifestations
Paralysis
Perfusion
Shock, Cardiogenic
Spinal Cord*
Urinary Bladder

Figure

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  Figure 1. Axial (A) and sagittal (B) magnetic resonance imaging demonstrating diffuse swelling with increased T2 signal intensity (arrows) of the spinal cord (T5–conus medullaris).

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