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01 February 2006

Painless aortic dissection manifestating as acute stroke. Case report

Dagmara Mirowska-Guzel, Tomasz Litwin, Anna Rozenfeld, Adam Kobayashi, Anna Czlonkowska

Case Rep Clin Pract Rev 2006; 7:1-3 :: ID: 445550

Abstract

Background: In some cases aortic dissection (AD) may manifests as acute ischemic stroke. However, thrombolytic therapy, reserved for first 3 hours after stroke onsets, is contraindicated in AD. For that reason all cases of strokes, especially those qualified to thrombolysis, should be carefully diagnosed and selected.
Case Report: We present the case of 52-year old male patient who was admitted to neurological department
with symptoms of acute ischemic stroke. Due to spontaneous neurological improvement the patient did not receive thrombolytic treatment as it was planned and asymmetry of patient’s blood pressure drew duty neurologist’s attention. Results of additional examination (doppler investigation, heart USG, chest CT) allowed to make the diagnosis of aortic dissection. Patient’s condition worsened within next 12 hours and he did not undergo heart surgery. He died with symptoms of cardiac tamponade with cardiac arrest.
Conclusions: We postulate that in patients with symptoms of ischemic stroke qualified to thrombolytic therapy the symmetry of the pulse and blood pressure is extremely important and should be routinely
checked according to possibility of aortic dissection.

Keywords: Aortic dissection, Stroke, Thrombolytic Therapy

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923