Recurrent, massive pulmonary embolism in chronic myelopathy: A case report

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Abstract

Study design:Case report.Objectives:The aim of this report was to describe an example of pulmonary embolism (PE), recently suggested to be highly prevalent in persons with chronic spinal cord lesions.Setting:Veterans Affairs Hospital, Boston, MA, USA.Methods:Chart review.Results:A 60-year-old man with paraplegia, T10 motor complete, underwent laminectomy for correction of an arteriovenous malformation. After 41 days, he sustained a massive PE-suggested by right bundle branch block (RBBB) on an electrocardiogram (ECG) and diagnosed by perfusion lung scanning. He was treated with anticoagulants, the lung scan and RBBB resolving within 1 month of initiating treatment. After 5 years, he developed vertebral osteomyelitis at L5-S1 and was treated with antibiotics and bed rest. After 7 days, he was mobilized to a wheelchair, and during a transfer back to bed, he developed anxiety, dyspnea, fluctuating consciousness, low blood pressure and RBBB, absent by ECG 4 days earlier. He expired 20 min after onset of symptoms. The autopsy revealed a fresh thromboembolus occluding both main stem branches of the pulmonary artery.Conclusion:Massive PE after surgery in a patient with chronic paraplegia recurred 5 years later in association with severe infection and mobilization after bed rest, which resulted in death. © 2011 International Spinal Cord Society All rights reserved.

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Frisbie, J. H., & Sharma, G. V. R. K. (2011). Recurrent, massive pulmonary embolism in chronic myelopathy: A case report. Spinal Cord, 49(2), 318–320. https://doi.org/10.1038/sc.2010.54

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