Acute aortic dissection complicated by acute ischemic stroke: diagnostic challenges

2012 ◽  
Vol 30 (9) ◽  
pp. 2070-2073 ◽  
Author(s):  
Cheng-Hsuan Ho ◽  
Yu-long Chen ◽  
Yen-Yue Lin ◽  
Wen-I Liao ◽  
Chih-Yuan Lin ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Aortic Dissection ◽  
Acute Ischemic Stroke ◽  
Acute Aortic Dissection

Successful carotid artery stenting in patients with aortic dissection

2020 ◽  
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Aortic Dissection ◽  
Cerebral Infarction ◽  
Acute Ischemic Stroke ◽  
Aortic Arch ◽  
Common Carotid Artery ◽  
Carotid Artery Stenting ◽  
Acute Aortic Dissection ◽  
Optimal Timing

Background: There are no guidelines for the optimal timing of surgery (emergency vs. delayed) for ascending aortic dissection with acute ischemic stroke. We retrospectively compared the prognoses and radiological and clinical findings for concomitant aortic dissection and ischemic stroke in a series of case reports. Case presentation: Three patients presented with left hemiparesis. Patient 1 underwent surgery for acute aortic dissection without treatment for acute ischemic stroke. In Patient 2, emergency stenting could not be performed due to cardiac tamponade and hypotension. Therefore, emergency acute aortic dissection surgery was performed. Patient 3 underwent emergency right common carotid artery stenting followed by surgery for acute aortic dissection. Brain perfusion computed tomography angiography (CTA) was performed to diagnose severe stenosis of the right common carotid artery or occlusion concomitant with acute aortic dissection involving the aortic arch with a cerebral perfusion mismatch in all the patients. Patient 3 had postoperative local cerebral infarction, whereas patients 1 and 2 (without stent insertion) had extensive postoperative cerebral infarction. Conclusion: Patient 3 showed a better prognosis than patients without stent treatment. We suggest that perfusion CTA of the aortic arch in suspected acute ischemic stroke can facilitate early diagnosis and prompt treatment in similar patients.

scholarly journals Acute ischemic stroke caused by Stanford type A acute aortic dissection

Nosotchu ◽  
2018 ◽  
Vol 40 (6) ◽  
pp. 432-437 ◽  
Author(s):  
Masatoshi Koga ◽  
Yasuyuki Iguchi ◽  
Tomoyuki Ohara ◽  
Yoshio Tahara ◽  
Yousuke Inoue ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Aortic Dissection ◽  
Acute Ischemic Stroke ◽  
Acute Aortic Dissection ◽  
Type A

scholarly journals The differential diagnosis of acute ischemic stroke and acute aortic dissection in clinical characters

Nosotchu ◽  
2014 ◽  
Vol 36 (6) ◽  
pp. 414-418
Author(s):  
Tatsuya Ueno ◽  
Tomoya Kon ◽  
Yukihisa Hunamizu ◽  
Rie Haga ◽  
Haruo Nishijima ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Ischemic Stroke ◽  
Aortic Dissection ◽  
Acute Ischemic Stroke ◽  
Acute Aortic Dissection

Abstract TP144: Mechanisms And Prognosis Of Acute Ischemic Stroke Related To Acute Aortic Dissection

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Seung-Jae Lee ◽  
Dong-Suk Shim ◽  
Si-Ryung Han
Keyword(s):  
Ischemic Stroke ◽  
Aortic Dissection ◽  
Early Onset ◽  
Acute Aortic Dissection ◽  
Type A ◽  
Posterior Circulation ◽  
Type B ◽  
Delayed Onset ◽  
Bilateral Carotid ◽  
Type B Dissection

Background: Acute aortic dissection (AD) is one of the lethal cardiac diseases involving the aorta. Although pain is a typical symptom, stroke may not rarely occur with the occlusive dissection of aortic branches or hypotension under the condition of AD. We attempted to explores the clinical features, possible mechanisms and prognosis of acute ischemic stroke (AIS) related to AD Method: Medical records of 278 consecutive patients with AD (165 with type A and 113 with type B dissection) over 11.5 years were retrospectively analyzed for clinical history, CT or MRI findings and outcome. AIS were categorized into early- or delayed-onset stroke. Early-onset stroke was defined as an AIS presented at admission, and delayed-onset stroke was an AIS which were developed during the two months after the first admission. Results: 26 (9.4%) patients experienced an ischemic stroke, which included 22 with type A and 4 with type B dissection. 8 patients (2.9%) including a case of TIA had an early-onset stroke, whereas delayed-onset stroke occurred in 18 patients (6.5%) postoperatively or under medical treatment. Early-onset stroke was all referable to the anterior circulation, predominantly right-sided (87.5%). One or more main branches of the aortic arch were involved in 6 out of 8 patients (75%) with early-onset stroke. Innominate artery was most frequently involved (75.0%). In contrast, delayed-onset stroke affected similarly bilateral carotid territories, and also included lesions in bilateral carotid, posterior-circulation and anterior/posterior-circulation territories. Among the 26 patients, 8 patients (30.8%) expired within 6 months of the disease onset (3 cases from hemispheric stroke with brain herniation, 2 cases from aortic rupture, 2 cases from sepsis with multiple organ failure and a case from mesentery ischemia and renal failure). Additionally, 9 patients (34.6%) remained functionally dependent six months later. Conclusion: AD not infrequently causes AIS with grave prognosis, especially in patients with type A dissection. The presumed mechanisms were aortic branch dissection causing luminal occlusion and emboli from thrombosed vascular lumen and hypotension under the condition of AD.

Acute ischemic stroke in aortic dissection: Case report and review of literature

2010 ◽  
Vol 64 (8) ◽  
pp. 385 ◽  
Author(s):  
VS Ramalingam ◽  
S Sudhakar ◽  
R Sinnakirouchenan ◽  
AV Brasch
Keyword(s):  
Ischemic Stroke ◽  
Case Report ◽  
Aortic Dissection ◽  
Acute Ischemic Stroke ◽  
Review Of Literature

Aortic Dissection Presenting as an Acute Ischemic Stroke for Thrombolysis

2005 ◽  
Vol 15 (3) ◽  
pp. 281-283 ◽  
Author(s):  
Ken Uchino ◽  
Anthony Estrera ◽  
Sergio Calleja ◽  
Andrei V. Alexandrov ◽  
Zsolt Garami
Keyword(s):  
Ischemic Stroke ◽  
Aortic Dissection ◽  
Acute Ischemic Stroke
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