TITLE:
Sudden Paraplegia Revealed Acute Aortic Dissection Type A with Adamkiewicz Artery’s Involvement: A Congolese Case Report
AUTHORS:
Thibaut Naïbe Gankama, Jospin Karel Makani Bassakouahou, Eric Gibrel Kimbally Kaky, Rog Paterne Bakekolo, Solange Flore Mongo Ngamami, Christian Michel Kouala Landa, Kivié Ngolo Letomo, Bijou Moualengue, Franck Bienvenu Ekoba Othendet, Ruddy Junior Taty, Rud Ampat Effonouan, Méo Stéphane Ikama
KEYWORDS:
Aortic Dissection, Paraplegia, Spinal Cord, Malperfusion, Ischeamia
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.15 No.12,
December
10,
2025
ABSTRACT: Aortic dissection with neurological symptoms is a usual presentation and rare condition. It poses a major diagnostic challenge due to the risk of misdiagnosis and worse prognosis (functional or vital). We present the clinical case of a 53-year-old female patient admitted for chest pain and sudden onset paraplegia in cardiology department. Her medical history included hypertension and diabetes mellitus. Physical examination showed paraplegia associated to anesthesia of legs and painless back. BP: 120/60 mmHG. Cariopulmonary auscultation was normal. Pulses presents. Chest X-ray revealed mediastinal widening. Cardiac ultrasound revealed an intimal tear of aortic dissection and severe aortic insufficiency. Chest CT angiography showed a Stanford type A aortic dissection with left renal infarction. Spinal cord MRI was not available. In the absence of a cardiac surgery center, the patient died one month later from trophic and infectious complications. Paraplegia leads to aortic dissection when there is no pain in the back and occurs suddenly. Hypertension is the common cause in subafrica. Early diagnosis and management prevent death.