title: Putamen hemorrhage occurred simultaneously with Stanford type A acute aortic dissection: a case report.
abstract: This case report describes a 60-year-old man found unresponsive on the road. He was later admitted to our emergency department (ED) with consciousness disturbance and decorticate rigidity. Computed tomographic imaging revealed coexisting left putamen hemorrhage and Stanford type A acute aortic dissection. Decompressive craniectomy and hematoma evacuation were performed, but he died during his second hospital day. Morbid anatomy proved aortic dissection from the ascending aorta to left common iliac artery with pericardial effusion up to 500 mL. Brain hemorrhage and acute aortic dissection share several risk factors including hypertension and atherosclerosis, but few cases have been reported with brain hemorrhage and aortic dissection occurring simultaneously. Diagnosis for aortic dissection is difficult, especially when the patient has consciousness disturbance because of brain hemorrhage. Consequently, coexistence of these 2 conditions might be missed frequently in emergency settings. Therefore, wider knowledge of this case is important to inform others to suspect and investigate aortic dissection in cases of brain hemorrhage.
authors.affiliation: Department of Emergency Medicine and Critical care, University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan. sonopy77@yahoo.co.jp
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Sonoo
authors.forename: Tomoki
authors.initials: T
authors.lastname: Wada
authors.forename: Ryota
authors.initials: R
authors.lastname: Inokuchi
authors.forename: Kensuke
authors.initials: K
authors.lastname: Nakamura
authors.forename: Susumu
authors.initials: S
authors.lastname: Nakajima
authors.forename: Naoki
authors.initials: N
authors.lastname: Yahagi
mesh_terms: D000784:Aortic Dissection / Q000150:complications* / Q000000981:diagnostic imaging; D017545:Aortic Aneurysm, Thoracic / Q000150:complications* / Q000000981:diagnostic imaging; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D008875:Middle Aged; D059906:Neuroimaging; D020146:Putaminal Hemorrhage / Q000150:complications* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed