Pseudoaneurysm of the Internal Iliac Artery: a Rare Cause of Bilateral Lumbosacral Plexopathy
SF Low, TY Kew, CS Ngiu, NA Bakar
Hong Kong J Radiol 2014;17:36-40
DOI: 10.12809/hkjr1413170
Pseudoaneurysms of the internal iliac artery are uncommon and are usually associated with trauma. Rarely, they expand subclinically for years and cause significant compression of adjacent vital structures. We report an unusual case of delayed onset bilateral lumbosacral plexopathy resulting from direct compression due to a right internal iliac artery pseudoaneurysm. The neurological symptoms of the patient began 2 years after a stab injury to the right gluteal region. To the best of our knowledge, this is the first report of bilateral lumbosacral plexopathy secondary to a solitary internal iliac artery pseudoaneurysm that manifested clinically 2 years after the injury. This report illustrates how a pseudoaneurysm of the internal iliac artery (an extraspinal pathology) has the potential to cause lumbosacral plexopathy, and describes relevant imaging findings.
中文摘要
假性動脈瘤的髂內動脈：雙側腰神經叢病變的罕見病因
劉淑芬、丘天恩、魏財順、NA Bakar
髂內動脈假性動脈瘤很罕見，通常與創傷有關。髂內動脈假性動脈瘤極少呈亞臨床性隱匿擴張數年而顯著壓迫鄰近重要器官。本文報告一宗因右髂內動脈假性動脈瘤直接壓迫誘發的遲發性雙側腰骶神經叢病變的罕見病例。病人在右臀區被刺傷，兩年後開始出現神經系統症狀。據我們所知，這是首宗創傷兩年後才有臨床表現，繼發於孤立髂內動脈假性動脈瘤的雙側腰骶神經叢病變的病例報告。本文闡明髂內動脈的假性動脈瘤（髓外病理學）如何具有導致腰骶部神經叢病變的潛能，並描述了相關的影像學表現。