Spinal Cord Infarction After Transarterial Chemoembolization for Hepatocellular Carcinoma

Sang-Geun Lee; Sung Min Cho; Kum Whang; Yeon Gyu Jang; Jongyeon Kim; Jongwook Choi

doi:10.13004/kjnt.2022.18.e65

Spinal Cord Infarction After Transarterial Chemoembolization for Hepatocellular Carcinoma

Korean J Neurotrauma. 2022 Oct 25;18(2):404-409. doi: 10.13004/kjnt.2022.18.e65. eCollection 2022 Oct.

Authors

Sang-Geun Lee¹, Sung Min Cho¹, Kum Whang¹, Yeon Gyu Jang¹, Jongyeon Kim¹, Jongwook Choi¹

Affiliation

¹ Department of Neurosurgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.

Abstract

Transarterial chemoembolization (TACE) is an effective treatment for unresectable hepatocellular carcinoma (HCC). It is considered relatively safe. However, fatal complications such as pulmonary edema and liver abscesses can occur. Spinal infarction due to local embolism of the central nervous system after TACE is a very rare, but fatal complication. Here, we report a case of spinal cord infarction after TACE for ruptured HCC. Paraplegia occurred at the T10 sensory level 6 hours after the procedure. The patient received steroid megadose therapy but died 5 days later due to exacerbation of metabolic acidosis and blood loss. This case demonstrates the need for a comprehensive and extensive study of arterial blood flow prior to angiography.

Keywords: Embolization; Hepatocellular carcinoma; Spinal cord ischemia.

Publication types

Case Reports