Ischaemic infarction masking aortic dissection: a pitfall to be avoided before thrombolysis.
Acute aortic dissection complicated by stroke is not uncommon but may be difficult to evaluate, especially in patients with impaired mental status. We report a patient who had evidence of an ischaemic stroke but was fortuitously not given thrombolytic treatment. She was subsequently found to have an extensive aortic dissection involving both carotid arteries. The decision of whether to give thrombolytic treatment is understandably an urgent one, but careful attention should be paid to subtle signs and symptoms such as atypical chest pain and carotid bruits that might suggest aortic dissection, especially involving the carotid arteries. There should be a high index of suspicion for acute aortic dissection in such cases and a low threshold for performing carotid ultrasound.
Yeh
Ju Fen
JF
Department of Neurology, Mackay Memorial Hospital, Taipei, Taiwan.. joyce0120@yahoo.com.tw
Po
Helen
H
Chien
Chen Yen
CY
D000784:Aortic Dissection / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D001014:Aortic Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D000075202:Contraindications; D005260:Female; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000150:complications* / Q000188:drug therapy*; D008875:Middle Aged; D011859:Radiography; D015912:Thrombolytic Therapy; D016896:Treatment Outcome