title: Early acute ischaemic stroke in two patients with acute type B aortic dissection: an unusual complication.
abstract: Aortic thoracic dissection (AD) is a serious cardiovascular disease. According to the Stanford classification; type A involves the ascending aorta and type B the descending distal to the left subclavian artery. Neurological complications secondary to AD are devastating. Ischaemic stroke and hypoxic encephalopathy are early-recognised complications of type A as the arch vessels can be involved AD. Although, late ischaemic stroke had been reported in 1.4-5% of patients with type B dissection, early stroke is very unusual as it cannot be simply explained by AD anatomical pathogenesis. We report two patients who presented with type B AD complicated by early ischaemic strokes. Work-up revealed significant cardiomyopathies in both patients but with left ventricle thrombus in one. In both patients the strokes were felt to be of cardioembolic origin.
authors.affiliation: Pulmonary, Critical Care and Sleep Department, George Washington University, Washington DC, USA.
authors.forename: Abdullah
authors.initials: A
authors.lastname: AlGhamdi
authors.affiliation: Neurology department, George Washington University, Washington DC, USA.
authors.forename: Saeed
authors.initials: S
authors.lastname: Alqahtani
authors.affiliation: Radiology Department, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio, USA.
authors.forename: Meagan
authors.initials: M
authors.lastname: Ricketti
authors.affiliation: Cardiothoracic Surgery Department, FACS, George Washington University, Washington DC, USA.
authors.forename: Salim
authors.initials: S
authors.lastname: Aziz
mesh_terms: D000328:Adult; D000784:Aortic Dissection / Q000145:classification* / Q000175:diagnosis*; D001011:Aorta; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis*; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000150:complications*; D013348:Subclavian Artery; D014057:Tomography, X-Ray Computed