A Case of Paradoxical Embolism Causing Anterior Spinal Cord Syndrome and Acute Myocardial Infarction Following the Intradiscal Oxygen-Ozone Therapy

We report a case of a 66-year-old female who burst into flaccid paralysis of the lower extremities, accompanied by loss of pain and temperature sensation below T4 level, during an oxygen–ozone injection for disc herniation. Half an hour later, she suffered from chest pain. Magnetic resonance imaging...

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Autores principales: He, Runcheng, Huang, Qing, Yan, Xinxiang, Liu, Yunhai, Yang, Jie, Chen, Xiaobin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2019
Materias:
Neurology
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6395432/
https://www.ncbi.nlm.nih.gov/pubmed/30853936
http://dx.doi.org/10.3389/fneur.2019.00137
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author He, Runcheng
Huang, Qing
Yan, Xinxiang
Liu, Yunhai
Yang, Jie
Chen, Xiaobin
author_facet He, Runcheng
Huang, Qing
Yan, Xinxiang
Liu, Yunhai
Yang, Jie
Chen, Xiaobin
author_sort He, Runcheng
collection PubMed
description We report a case of a 66-year-old female who burst into flaccid paralysis of the lower extremities, accompanied by loss of pain and temperature sensation below T4 level, during an oxygen–ozone injection for disc herniation. Half an hour later, she suffered from chest pain. Magnetic resonance imaging (MRI) showed long segment hyperintensity in the thoracic spinal cord from T2 to 10 level on sagittal T2-weighted images (T2WI). The electrocardiogram (ECG) showed ST-segment elevation in V1–V6 leads. She was diagnosed with spinal cord infarction and ST-elevation myocardial infarction (STEMI). Transthoracic echocardiography with saline contrast showed existence of a large patent foramen ovale (PFO) correlating with the detection of massive microbubbles in the left atrium. We discuss the potential role of paradoxical embolism in spinal cord infarction and myocardial infarction.
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spelling pubmed-63954322019-03-08 A Case of Paradoxical Embolism Causing Anterior Spinal Cord Syndrome and Acute Myocardial Infarction Following the Intradiscal Oxygen-Ozone Therapy He, Runcheng Huang, Qing Yan, Xinxiang Liu, Yunhai Yang, Jie Chen, Xiaobin Front Neurol Neurology We report a case of a 66-year-old female who burst into flaccid paralysis of the lower extremities, accompanied by loss of pain and temperature sensation below T4 level, during an oxygen–ozone injection for disc herniation. Half an hour later, she suffered from chest pain. Magnetic resonance imaging (MRI) showed long segment hyperintensity in the thoracic spinal cord from T2 to 10 level on sagittal T2-weighted images (T2WI). The electrocardiogram (ECG) showed ST-segment elevation in V1–V6 leads. She was diagnosed with spinal cord infarction and ST-elevation myocardial infarction (STEMI). Transthoracic echocardiography with saline contrast showed existence of a large patent foramen ovale (PFO) correlating with the detection of massive microbubbles in the left atrium. We discuss the potential role of paradoxical embolism in spinal cord infarction and myocardial infarction. Frontiers Media S.A. 2019-02-22 /pmc/articles/PMC6395432/ /pubmed/30853936 http://dx.doi.org/10.3389/fneur.2019.00137 Text en Copyright © 2019 He, Huang, Yan, Liu, Yang and Chen. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
He, Runcheng
Huang, Qing
Yan, Xinxiang
Liu, Yunhai
Yang, Jie
Chen, Xiaobin
A Case of Paradoxical Embolism Causing Anterior Spinal Cord Syndrome and Acute Myocardial Infarction Following the Intradiscal Oxygen-Ozone Therapy
title A Case of Paradoxical Embolism Causing Anterior Spinal Cord Syndrome and Acute Myocardial Infarction Following the Intradiscal Oxygen-Ozone Therapy
title_full A Case of Paradoxical Embolism Causing Anterior Spinal Cord Syndrome and Acute Myocardial Infarction Following the Intradiscal Oxygen-Ozone Therapy
title_fullStr A Case of Paradoxical Embolism Causing Anterior Spinal Cord Syndrome and Acute Myocardial Infarction Following the Intradiscal Oxygen-Ozone Therapy
title_full_unstemmed A Case of Paradoxical Embolism Causing Anterior Spinal Cord Syndrome and Acute Myocardial Infarction Following the Intradiscal Oxygen-Ozone Therapy
title_short A Case of Paradoxical Embolism Causing Anterior Spinal Cord Syndrome and Acute Myocardial Infarction Following the Intradiscal Oxygen-Ozone Therapy
title_sort case of paradoxical embolism causing anterior spinal cord syndrome and acute myocardial infarction following the intradiscal oxygen-ozone therapy
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6395432/
https://www.ncbi.nlm.nih.gov/pubmed/30853936
http://dx.doi.org/10.3389/fneur.2019.00137
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