Recurrent transient ischemic attacks as the initial presenting manifestation of type A aortic dissection.
A case is reported of an 84-year-old woman with recurrent episodes of aphasia and right-sided weakness with spontaneous complete resolution associated with hypotension. She subsequently developed lower gastrointestinal bleeding, ischemic toes, and anuria without associated chest pain. An emergent transesophageal echocardiography showed a type A aortic dissection with aortic valve insufficiency and tamponade. Emergent thoracotomy was performed, which confirmed a severe acute type A aortic dissection. This is a reported case of acute painless aortic dissection presenting initially as recurrent transient ischemic attacks. The etiology of focal neurologic deficits should be crucially determined by an experienced clinician prior to thrombolytic administration. This case illustrates the importance of aortic disease in the etiology of acute stroke syndromes.
Department of Neurology, Case Western Reserve University School of Medicine, University Hospitals of Cleveland, Cleveland, OH 44106-5000, USA. ooz@po.cwru.edu
Osama O
OO
Zaidat
Eroboghene E
EE
Ubogu
Alan J
AJ
Lerner
D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000175:diagnosis*; D001014:Aortic Aneurysm / Q000175:diagnosis*; D001021:Aortic Valve / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D017548:Echocardiography, Transesophageal; D005260:Female; D006349:Heart Valve Diseases / Q000175:diagnosis; D006801:Humans; D002546:Ischemic Attack, Transient / Q000175:diagnosis*; D012008:Recurrence; D014057:Tomography, X-Ray Computed; D017585:Ultrasonography, Doppler, Transcranial