Neurologic complications of type I aortic dissection.
BACKGROUND
Aortic dissection (AoD) is characterized by a transverse intimal tear that in most cases occurs in the right lateral wall of the ascending aorta. Neurological deficit is seen as an initial manifestation in about 20% of patients (8%-33%).


OBJECTIVE
To analyze the frequency of these complications and the underlying pathogenic mechanisms.


METHODS
Retrospective review of the neurologic complications of patients with type I AoD who underwent surgical treatment between January 1988/April 1996.


RESULTS
We report 24 patients. Nine (37.7%) developed neurologic symptoms which we have classified as follows: Hypoxic encephalopathy, 5 (55.5%); ischemic stroke, 2 (22.2%); ischemic neuropathy, 2 (22.2%) and spinal cord ischemia, 1 (11.1%). One is included in both first and third group.


CONCLUSIONS
Neurologic complications are frequent in type I AoD, mainly focal or global cerebral ischemia. The former could be due to advancement of the false channel towards the aortic arch vessels and the latter to global central nervous system hypoperfusion.
Blanco
M
M
Department of Neurology, Hospital Universitario La Paz, Universidad Autónoma de Madrid, Spain.
Díez-Tejedor
E
E
Larrea
J L
JL
Ramírez
U
U
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta; D001019:Aortic Rupture / Q000150:complications* / Q000000981:diagnostic imaging*; D001027:Aortography; D001037:Aphasia / Q000175:diagnosis / Q000209:etiology*; D001921:Brain / Q000098:blood supply; D002545:Brain Ischemia / Q000175:diagnosis / Q000209:etiology*; D003244:Consciousness Disorders / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013118:Spinal Cord Diseases / Q000175:diagnosis / Q000209:etiology*; D014057:Tomography, X-Ray Computed