Acute aortic dissection with new massive cerebral infarction - a successful repair with ligature of the right common carotid artery.
It remains unclear whether or not the infarcted brain caused by aortic dissection should be reperfused when an emergency operation is needed for aortic arch dissection. A 64-year-old woman presented with severe back pain and syncope with a sudden left hemiplegia. CT scan demonstrated an aortic dissection of the entire aorta, obstruction of the right common carotid artery by extended aortic dissection, cerebral infarction of the right middle cerebral artery territory, brain edema and pericardial effusion. Though she was unable to communicate with us, she underwent an emergent aortic arch replacement and ligature of the right common carotid artery nine hours after the onset of stroke, when massive cerebral infarction was established. She survived the operation and regained full consciousness. When brain infarction was established by extended aortic dissection in emergent aortic surgery, concomitant ligature of the responsible artery to the brain infarction may be allowed for avoiding cerebral damage leading to brain death.
Second Department of Surgery, Yamagata University School of Medicine, Yamagata, Japan.
Yasuhisa
Y
Shimazaki
Takashi
T
Minowa
Takao
T
Watanabe
Masataka
M
Koshika
Hideshi
H
Toyama
Kiyoshige
K
Inui
D001013:Aorta, Thoracic / Q000601:surgery*; D001019:Aortic Rupture / Q000150:complications* / Q000601:surgery*; D001929:Brain Edema / Q000517:prevention & control; D017536:Carotid Artery, Common / Q000601:surgery*; D005260:Female; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000209:etiology*; D020300:Intracranial Hemorrhages / Q000517:prevention & control; D008026:Ligation; D008875:Middle Aged