Aortic diseases: neurologic complications

Chandan Reddy MD (Dr. Reddy of the University of Iowa has no relevant financial relationships to disclose.)
Steven R Levine MD, editor. (Dr. Levine of the SUNY Health Science Center at Brooklyn has received honorariums from Genentech for service on a scientific advisory committee and a research grant from Genentech as a principal investigator.)
Originally released June 30, 1997; last updated April 7, 2009; expires April 7, 2012
Notice: This article has expired and is therefore not available for CME credit.

This article includes discussion of the neurologic complications of aortic diseases, abdominal aortic aneurysm, aneurysm of the aortic arch, aortitis, aortitis due to atherosclerosis, aortitis due to syphilis, cerebral and brainstem ischemia associated with diseases of the aorta, cerebral steal syndromes, coarctation of the aorta, dissecting aortic aneurysm, intermittent claudication, peripheral nerve dysfunction and sexual dysfunction associated with diseases of the aorta, and spinal cord ischemia associated with diseases of the aorta, thoracic aortic aneurysm. The foregoing terms may include synonyms, similar disorders, variations in usage, and abbreviations.

Overview

There is considerable ongoing interest in the clinical neurologic syndromes produced by compromise to the blood supply of the spinal cord as a result of diseases of, or operations on, the aorta. In this article, the authors cover the anatomy of the spinal cord and provide updated risk factors for surgery in aortic disease, the latest news on aortic atheromas and neurologic disease, and information about surgery and anesthesia in repairing disease of the aorta. In addition, they provide expanded information about aortic occlusion causing mononeuropathy and provide sections on aortic dissection, aortic occlusion, and treatments of aortic diseases.

Historical note and terminology

The anatomy of the blood supply to the spinal cord was initially described in 19th-century German literature in a series of papers published by Adamkiewicz (1881, 1882) and Kadyi (1886, 1889) (Goodin 1992). Adamkiewicz published a monograph, “On spinal cord vascularization,” which comprehensively described the artery that is named after him (Milen 1999).

Subsequent to these descriptions, there has been considerable ongoing interest in the clinical neurologic syndromes produced by compromise to the blood supply of the spinal cord as a result of diseases of, or operations on, the aorta.

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