Portal-systemic myelopathy after transjugular intrahepatic portosystemic shunt creation: Report of four cases

Mao Qiang Wang, Michael D. Dake, Zhi Peng Cui, Zhi Qiang Wang, Yu Ao Gao

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

The authors attempted to describe the clinical manifestations of portal-systemic myelopathy (PSM) after transjugular intrahepatic portosystemic shunt (TIPS) creation. PSM was developed in four of 212 (1.89%) patients who underwent TIPS procedures in our hospital. Three men and one woman, ranging in age from 41 to 56 years, with a history of posthepatitis cirrhosis and recurrent bleeding from gastroesophageal varices had intrahepatic shunts created with 10-mm-diameter Wallstents. Shunt patency was confirmed by color Doppler ultrasonography (US) in each patient after TIPS creation. Progressive spastic paraparesis involving the lower extremities occurred between 5 weeks and 5 months after TIPS creation in the four patients. Neurologic examination showed evidence of spasticity in all cases, with ankle clonus, extensor plantar responses, and lower extremity hyperreflexia. All sensory modalities remained intact. Cytologic examination of cerebrospinal fluid from each patient was normal. There was no evidence of spinal cord compression on the imaging studies. PSM is a rare syndrome that includes spastic paraparesis with intact sensation. Initially noted in patients who have undergone surgical placement of a portacaval shunt, it also may occur after TIPS creation.

Original languageEnglish (US)
Article number61514
Pages (from-to)879-881
Number of pages3
JournalJournal of Vascular and Interventional Radiology
Volume12
Issue number7
DOIs
StatePublished - Jan 1 2001
Externally publishedYes

Keywords

  • Complication
  • Hypertension
  • Interventional procedures
  • Portal
  • Portal-systemic encephalopathy
  • Portal-systemic myelopathy
  • Portosystemic
  • Shunt

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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