RECOVERY FROM PARAPLEGIA FOLLOWING AORTIC SADDLE EMBOLISM - CASE-REPORT

An aortic saddle embolus causing paraplegia is rare and even rarer is a documentation of neurological recovery from this event. A 47 year ol d male presented with absent pulsations in the lower limbs and paraple gia, both of sudden onset. He underwent immediate bilateral transfemor al embolectomy. The postoperative period was stormy. The paraplegia re covered over a period of 2 months and he could walk to his place of wo rk after 6 months. The rare combination of saddle embolus and parapleg ia is discussed. An attempt has been made to verify the hypothesis of Dickson et al which states that a low origin of the great radicular ar tery (GRA) below T12 level may be responsible for paraplegia when obst ructed by a saddle embolus. We found the GRA arising at L2 vertebral l evel in this patient. Postoperative selective spinal arteriogram and m agnetic resonance imaging (MRI) of the spinal cord showed a patent GRA and normal spinal cord structure respectively. Early surgical interve ntion in restoring the blood flow into the GRA may prevent severe hist ological changes hitherto responsible for nonrecovery from paraplegia in the earlier reports.