title: Identification of painless aortic dissection before thrombolytic treatment for acute ischemic stroke.
abstract: Early detection of acute ischemic stroke secondary to painless aortic dissection is a challenge for emergency physicians, especially when under the stress of the 3-hour golden time window for thrombolytic therapy. We reported a 57-year-old man with acute right hemisphere watershed ischemic stroke caused by painless type A aortic dissection was diagnosed in time with computed tomographic (CT) angiography. The possible detrimental impact which may have been incurred by thrombolytic therapy was avoided. We suggest that cerebral CT angiography, covering from the aortic arch to intracranial arteries, should be performed in acute ischemic stroke patients, particularly in those with watershed CT perfusion deficits, to exclude the possibility of aortic dissection before thrombolytic treatment.
authors: Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan.
authors: Chen-Hsiung
authors: CH
authors: Huang
authors: Hui-Chun
authors: HC
authors: Huang
authors: Kang-Hsu
authors: KH
authors: Lin
authors: Wei-Kung
authors: WK
authors: Chen
authors: Chon-Haw
authors: CH
authors: Tsai
mesh_terms: D000784:Aortic Dissection / Q000000981:diagnostic imaging*; D000792:Angiography; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging*; D002545:Brain Ischemia / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000000981:diagnostic imaging* / Q000188:drug therapy; D015912:Thrombolytic Therapy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome