Spinal cord infarction during physical exertion due to polycythemia vera and aortoiliac occlusive disease: A case report

Medicine, 2018 · DOI: http://dx.doi.org/10.1097/MD.0000000000012181 · Published: August 31, 2018

Cardiovascular Science Neurology Rehabilitation

Simple Explanation

This case report describes a rare instance of spinal cord damage caused by a blood clotting disorder (polycythemia vera) in a man with blocked arteries. The patient experienced sudden paralysis after lifting a heavy object, highlighting how physical strain can trigger such events in susceptible individuals. The patient's condition improved with treatment, including blood thinning medication and rehabilitation, emphasizing the importance of identifying and addressing the underlying cause.

Study Duration

14 months

Participants

A 56-year-old man

Evidence Level

Level 4: Case Report

Key Findings

1
Spinal cord infarction can be caused by polycythemia vera (PV) in conjunction with aortoiliac occlusive disease, leading to aortic thrombosis.
2
Physical exertion may act as a trigger for spinal cord infarction in patients with risk factors for thrombotic events.
3
Comprehensive etiological workup is crucial for spinal cord infarction patients to guide specific treatment strategies and improve outcomes.

Research Summary

This case report details a 56-year-old man who developed spinal cord infarction due to polycythemia vera and aortoiliac occlusive disease after heavy physical exertion. The patient presented with acute paraplegia and urinary retention, and was diagnosed with PV after workup for elevated hemoglobin levels. Treatment included anticoagulation, phlebotomy, hydroxyurea, and rehabilitation, leading to improved motor function and continence.

Practical Implications

Diagnostic Importance

Emphasizes the need for thorough investigation of underlying causes in spinal cord infarction cases to tailor treatment.

Risk Awareness

Highlights the potential risk of physical exertion as a trigger for spinal cord infarction in patients with predisposing conditions.

Patient Education

Suggests educating at-risk patients about neurological deficit symptoms during and after exercise to facilitate early intervention.

Study Limitations

1
Smoking is another vascular risk factor the patient has aside from PV.
2
The correlation between spinal cord infarction and PV in this patient is thus arbitrary.
3
Further research is necessary before deﬁnite causal relationship can be established.

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