Intravenous recombinant tissue plasminogen activator thrombolysis in a patient with acute ischemic stroke secondary to aortic dissection.
BACKGROUND
Acute ischemic stroke secondary to aortic dissection (AoD) is challenging in the era of thrombolysis owing to the diagnostic difficulty within a narrow time window and the high risk of complications.


METHODS
A 64-year-old woman with middle cerebral artery occlusion syndrome admitted to the emergency room within intravenous recombinant tissue plasminogen activator (rt-PA) time window. Her neurological symptoms improved during thrombolysis, but chest and abdominal pain developed. Repeated history-taking, physical examination, and imaging studies led to the timely diagnosis and surgical treatment of AoD, which produced a successful outcome.


CONCLUSIONS
Clinical suspicion is invaluable for the diagnosis of this rare cause of stroke. Considering the stroke mechanism and complications, the risks of thrombolysis might outweigh its benefits.
Hong
Keun-Sik
KS
Department of Neurology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.
Park
So-Young
SY
Whang
Seon-Il
SI
Seo
So-Young
SY
Lee
Dong-Ha
DH
Kim
Han-Joon
HJ
Cho
Joong-Yang
JY
Cho
Yong-Jin
YJ
Jang
Woo-Ik
WI
Kim
Chang Young
CY