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{
    "pk": 7674,
    "title": "“I Can’t Walk!” Acute Thrombosis of Descending Aorta Causing Paraplegia",
    "subtitle": null,
    "abstract": "A 50-year-old man presented to the emergency department (ED) with acute, bilateral lower extremity weakness and loss of sensation, as well as absent pulses bilaterally. Computed tomography angiography showed complete occlusion of the aorta below the inferior mesenteric artery, extending to the iliac bifurcations. Echocardiographic findings showed severe systolic dysfunction (ejection fraction of 15%) and cryptic cardiogenic shock in spite of stable vital signs. Prior to early operative intervention, an early goal-oriented hemodynamic strategy of shock management resulted in the resolution of motor and sensory deficits. After definitive surgical intervention, the patient was discharged neurologically intact. Acute aortic occlusion is frequently accompanied by myocardial dysfunction, which can be from mild to severe. The most severe form can even occur with normalvital signs or occult cardiogenic shock. Early detection and goal-directed preoperative hemodynamic optimization, along with surgical intervention in the ED, is required to optimize outcomes. [West J Emerg Med. 2013;14(5):424–427.]",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution-NonCommercial  4.0",
        "short_name": "CC BY-NC 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by-nc/4.0"
    },
    "keywords": [
        {
            "word": "Aortic Embolism"
        },
        {
            "word": "cardiogenic shock"
        },
        {
            "word": "early goal directed therapy"
        },
        {
            "word": "Emergency Medicine"
        }
    ],
    "section": "Diagnostic Acumen",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/1kx297bp",
    "frozenauthors": [
        {
            "first_name": "Matthew",
            "middle_name": "Lee",
            "last_name": "Mitchell",
            "name_suffix": "",
            "institution": "Henry Ford Health System",
            "department": "None"
        },
        {
            "first_name": "Elif",
            "middle_name": "",
            "last_name": "Yucebey",
            "name_suffix": "",
            "institution": "Henry Ford Hospital, Department of Emergency Medicine, Detroit, Michigan",
            "department": "None"
        },
        {
            "first_name": "Mitchell",
            "middle_name": "R",
            "last_name": "Weaver",
            "name_suffix": "",
            "institution": "Henry Ford Hospital, Department of Emergency Medicine, Detroit, Michigan",
            "department": "None"
        },
        {
            "first_name": "A",
            "middle_name": "Kathrin",
            "last_name": "Jaehne",
            "name_suffix": "",
            "institution": "Henry Ford Hospital, Department of Emergency Medicine, Detroit, Michigan",
            "department": "None"
        },
        {
            "first_name": "Emanuel",
            "middle_name": "P",
            "last_name": "Rivers",
            "name_suffix": "",
            "institution": "Henry Ford Hospital, Department of Emergency Medicine, Detroit, Michigan",
            "department": "None"
        }
    ],
    "date_submitted": "2013-01-07T21:40:47Z",
    "date_accepted": "2013-01-07T21:40:47Z",
    "date_published": "2013-09-15T07:00:00Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/7674/galley/4499/download/"
        }
    ]
}