Spinal cord infarction occurring during insertion of aortic graft

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Abstract
A case of central infarction of the lumbo-sacral cord following resection of a ruptured arteriosclerotic aneurysm of the abdominal aorta is reported. The lumbar radicular artery of Adamkiewicz and the abdominal aorta were occluded by clamp for a prolonged period of time, in the presence of hypotension. The site and distribution of the spinal cord lesion indicated that the most severe decrease in blood flow occurred in the border zone between the territories of the most caudal branches of the anterior and posterior spinal arteries. This type of hemodynamic failure can be produced by a variety of distant causes. Clinically, infarction in the central portion of the cord is indistinguishable from infarction in the anterior spinal artery territory due to direct occlusion of that vessel.

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