Traumatic transection of the aorta and thoracic spinal cord injury without radiographic abnormality in an adult patient.

PURPOSE: To describe a rare case of spinal cord injury without radiographic abnormalities (SCIWORA) associated with a traumatic aortic transection.

CASE REPORT: A 48-year-old man was transferred for endovascular treatment of a traumatic aortic transection. Primary traumatic paraplegia had been documented at the scene of the accident. No osseous or ligamentous injuries were found in the conventional radiographic images. The transection was treated successfully with an endovascular stent-graft, but the patient remained paraplegic. On the magnetic resonance images 8 days later, discrete trauma of the intraspinal ligament at T1/T2 was seen, without signs of injury to the myelum. The patient made a slow but incomplete recovery after that.

CONCLUSION

SCIWORA very rarely affects the thoracic spinal cord in adults; therefore, a vascular injury in relation to the trauma of the aorta is assumed. When spinal cord damage is noted after stent-grafting or open aortic surgery for traumatic transection, SCIWORA should be ruled out by history and neurological examination.