title: Carotid Ultrasonography Can Identify Stroke Patients Ineligible for Intravenous Thrombolysis Therapy due to Acute Aortic Dissection.
abstract: Acute aortic dissection is the most common acute aortic condition requiring urgent surgical therapy. Due to lack of typical symptoms, it is sometimes difficult to identify acute aortic dissection causing ischemic stroke. We report a case of a patient with acute ischemic stroke who was deemed ineligible for intravenous recombinant tissue plasminogen activator treatment based on a finding of acute aortic dissection detected by carotid ultrasonography. After urgent aortic replacement surgery, the patient recovered with no neurological deficit. This case underscores the crucial role of carotid ultrasonography for the investigation of possible underlying acute aortic dissection when considering the use of intravenous recombinant tissue plasminogen activator therapy for hyperacute stroke.
authors.affiliation: Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Suita, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Hama
authors.affiliation: Division of Stroke Care Unit, National Cerebral and Cardiovascular Center, Osaka, Suita, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Koga
authors.affiliation: Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Suita, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Tokunaga
authors.affiliation: Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Suita, Japan.
authors.forename: Hotake
authors.initials: H
authors.lastname: Takizawa
authors.affiliation: Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Suita, Japan.
authors.forename: Kotaro
authors.initials: K
authors.lastname: Miyashita
authors.affiliation: Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Suita, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Iba
authors.affiliation: Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Suita, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Toyoda
mesh_terms: D000784:Aortic Dissection / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D001014:Aortic Aneurysm / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D004608:Eligibility Determination; D005343:Fibrinolytic Agents / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011379:Prognosis; D020521:Stroke / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery; D015912:Thrombolytic Therapy / Q000379:methods; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D016896:Treatment Outcome; D014463:Ultrasonography / Q000379:methods
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
keywords: Acute stroke; aortic dissection; carotid ultrasound; recombinant tissue plasminogen activator