title: Aortic dissection presenting as an acute ischemic stroke for thrombolysis.
abstract: Thrombolysis for the treatment of acute ischemic stroke requires careful selection of patients. The authors report a case of aortic dissection presenting with acute ischemic stroke for which emergent ultrasonographic evaluation was helpful in the diagnosis and subsequent treatment. The patient presented with acute middle cerebral artery ischemic stroke symptoms and complained of bilateral ear and chest pain. Chest x-ray, cardiac enzymes, and transthoracic echocardiogram were normal, and she was considered for thrombolytic therapy. Carotid ultrasound revealed right common carotid occlusion that led to the diagnosis of aortic dissection, confirmed by chest computed tomography. An experienced sonographer with skills to perform rapid intra- and extracranial examinations may help to change the treatment plan for acute stroke patients.
authors.affiliation: Department of Neurology, University of Texas-Houston Medical School, Houston, TX, USA. uchinok@upmc.edu
authors.forename: Ken
authors.initials: K
authors.lastname: Uchino
authors.forename: Anthony
authors.initials: A
authors.lastname: Estrera
authors.forename: Sergio
authors.initials: S
authors.lastname: Calleja
authors.forename: Andrei V
authors.initials: AV
authors.lastname: Alexandrov
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Garami
mesh_terms: D000208:Acute Disease; D000784:Aortic Dissection / Q000175:diagnosis*; D001014:Aortic Aneurysm / Q000175:diagnosis*; D002545:Brain Ischemia / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008875:Middle Aged; D020521:Stroke / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy; D015912:Thrombolytic Therapy; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography