Usefulness of cervical magnetic resonance imaging for detecting type A acute aortic dissection with acute stroke symptoms.
Type A acute aortic dissection (TAAAD) sometimes presents with acute stroke-like symptoms. When intravenous tissue plasminogen activator (IV-tPA) therapy is considered for acute ischemic stroke, TAAAD must be excluded. Painless TAAAD presenting with acute stroke may be easily missed. Two cases of painless TAAAD presenting with acute stroke in which IV-tPA therapy was considered are reported. In these cases, cervical magnetic resonance angiography (MRA) was useful for detecting TAAAD, and IV-tPA therapy was canceled. The mottled high signal ("snowstorm") in the common carotid artery on cervical MRA is specific for TAAAD. We have thus named this phenomenon the "snowstorm sign" and believe it can help diagnose TAAAD.
Department of Neurosurgery, Cerebrovascular Research Institute, Eisyokai Yoshida hospital. Electronic address: hiroaki-matsu@umin.ac.jp.
Hiroaki
H
Matsumoto
Department of Neurosurgery, Cerebrovascular Research Institute, Eisyokai Yoshida hospital.
Yasuhisa
Y
Yoshida
Department of Neurology, Cerebrovascular Research Institute, Eisyokai Yoshida hospital.
Yutaka
Y
Hirata
D000368:Aged; D000784:Aortic Dissection / Q000000981:diagnostic imaging*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging*; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy; D005260:Female; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy; D007262:Infusions, Intravenous; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000098:blood supply; D020521:Stroke / Q000000981:diagnostic imaging* / Q000188:drug therapy; D010959:Tissue Plasminogen Activator / Q000009:adverse effects / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed
C067262:PLAT protein, human; D010959:Tissue Plasminogen Activator
Ischemic stroke; Magnetic resonance angiography; Tissue plasminogen activator; Type A acute aortic dissection