Türk Beyin Damar Hast Derg. 2021; 27(3): 242-245 | DOI: 10.5505/tbdhd.2020.04696

Beck syndrome in a young patient with respiratory arrest

Ýbrahim Acýr¹, Hacý Ali Erdoðan², Vildan Yayla^2
1Baþakþehir Çam and Sakura City Hospital, Department of Neurology, Istanbul, Turkey
²Bakýrköy Dr. Sadi Konuk Training and Research Hospital, Department of Neurology, Istanbul, Turkey

Anterior spinal artery (ASA) infarcts are also called Beck syndrome. It has a sudden onset and often has radicular or girdle like pain. Flask tetraplegia/paraplegia (within minutes and hours), flask bladder, thermoanesthesia, analgesia, flammable pain are other findings. A small number of ASA infarction cases in which onset with dyspnea or apnea have been reported. With this case report, it is aimed to keep in mind that the ASA infarcts can apply with respiratory arrest which is an atypical clinic. A 21-year-old female patient applied with weakness in the whole body and respiratory distress that developed suddenly. Respiratory arrest developed during her examinations, she was intubated and taken to the intensive care unit. Except for a vague upper respiratory tract infection and polycystic ovary syndrome, there was no medical histories. In her neurological examination, she was tetraplegic, deep tendon reflexes were hypoactive, Babinski sign was bilaterally positive. In addition to the Guillain-Barre and myasthenic crisis, examinations were planned for all differential diagnosis. Meanwhile in the cranial and cervical MR, a T2 hyperintense pathological signal was observed, which started from the bulbus level, followed along the cervical and upper thoracic vertebra. Spinal cord infarcts are extremely rare compared to cerebral infarcts. Infarcts are most frequently observed in the lower thoracic segments and conus medullaris. This young patient who applied with respiratory arrest and having a long segment anterior spinal infarction including bulbus, entire cervical and upper thoracic level, is presented because of its rarity.

Keywords: Anterior spinal artery, Beck syndrome, quadriparesis.

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Solunum arrestiyle getirilen genç bir hastada Beck sendromu

Ýbrahim Acýr¹, Hacý Ali Erdoðan², Vildan Yayla^2
1Baþakþehir Çam ve Sakura Þehir Hastanesi, Nöroloji Kliniði, Ýstanbul
²Bakýrköy Dr. Sadi Konuk Eðitim ve Araþtýrma Hastanesi, Nöroloji Kliniði, Ýstanbul

Anterior spinal arter (ASA) infarktlarý Beck sendromu olarak da isimlendirilmektedir. Ani baþlangýçlý olup sýklýkla radiküler veya kuþak tarzý aðrý vardýr. Flask tetrapleji/parapleji (dakikalar ve saatler içinde), flask mesane, termoanestezi, analjezi, yanýcý aðrýlar geliþebilecek diðer bulgulardýr. Dispne veya apne ile baþlayan az sayýda ASA enfarktüsü vakasý bildirilmiþtir. Bu olgu sunumuyla solunum arresti þeklinde atipik bir klinikle getirilen hastada ASA infaktýnýn da akýlda bulundurulmasý gerektiðini vurgulamak amaçlanmýþtýr. 21 yaþýnda bayan hasta tüm vücutta güçsüzlük ve aniden geliþen solunum sýkýntýsý ile baþvurdu. Tetkikleri sýrasýnda ani solunum arresti geliþmesi üzerine entübe edilerek yoðun bakým ünitesine alýndý. Olay öncesinde müphem bir üst solunum yolu enfeksiyonu geçirmesi, polikistik over sendromu dýþýnda öz ve soygeçmiþe ait bir özellik yoktu. Nörolojik muayenesinde, tetraplejik, derin tendon refleksleri abolik, taban cildi refleksi bilateral lakayttý. Guillain-Barre ve myastenik krize ek olarak, tüm ayýrýcý tanýlar için incelemeler planlandý. Bu arada çekilen kraniyal ve servikal MR'ýnda bulbus düzeyinden baþlayan, servikal ve üst torasik vertebra boyunca izlenen T2 hiperintens patolojik sinyal gözlendi. Spinal kord infarktlarý serebral infarktlarla karþýlaþtýrýldýðýnda oldukça nadir görülür. Ýnfarktlar en sýk alt torasik segmentlerde ve konus medüllariste gözlenir. Solunum arrestiyle getirilen, bulbus, tüm servikal ve üst torakal seviyeyi içine alan oldukça uzun segment anterior spinal infarktüs saptanan bu genç olgu, oldukça nadir görülmesi nedeniyle sunulmuþtur.

Anahtar Kelimeler: Anterior spinal arter, Beck sendromu, quadriparezi.

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