Abstract
An aortic arch aneurysm was diagnosed in an 84-year-old man. Since it was a high-risk case, it was followed up. However, the size of aneurysm had expanded to 70 mm on computed tomography (CT) the next year. An adaptation of stent graft (SG) placement was diagnosed, and the patient was admitted to our hospital for surgical repair. The SG had been placed at the bifurcation of the brachiocephalic artery at the 10th thoracic vertebra. Paralysis of the left leg appeared 6 hours after surgery, and ischemia of the spine was considered to be the cause. The urgent administration of methylprednisolone and naloxone were begun, and cerebrospinal fluid drainage (CSF-D) was started. The patient improved gradually, until he could walk with a cane on the 20th day after surgery. Postoperative CT showed no evidence of endoleak or thrombo-obstruction. This case indicated that CSF-D, methylprednisolone, and naloxone can be effective in early stage paralysis in such cases.
