Abstract
Acute aortic dissection is a life-threatening condition requiring immediate assessment and therapy. Rarely, aortic dis-section involves carotid arteries and manifest cerebral infarction. Here, we report a case of aortic dissection complicated with fatal cerebral infarction. A 83-year-old man, who suddenly suffered consciousness disturbance and right hemiparesis, was transferred to our hospital for the treatment of stroke. Magnetic resonance image revealed massive cerebral infarction in the left cerebral hemisphere as well as occlusion of the left internal carotid artery. Duplex ultrasonography demonstrated arterial dissection in the bilateral carotid arteries and the blood flow was compromised especially in the left side. Aortic dissection was confirmed by the contrast enhanced computed tomography. He was treated conservatively and died of cerebral hernia three days after the onset. In conclusion, aortic dissection may involve carotid artery and results in cerebral infarction. Ultrasound screening can aid timely diagnosis of aortic dissection and further management.
Highlights
Acute aortic dissection is a life-threatening condition requiring immediate assessment and therapy
Cerebral ischemic stroke is the most common neurologic manifestation associated with aortic dissection, affecting 10% - 30% of patients [1,2]
We report the case and the reports on cerebral ischemia due to the aortic dissection were reviewed
Summary
Acute aortic dissection is a life-threatening condition requiring immediate assessment and therapy. A patient suffering from aortic dissection often present with an insignificant or irrelevant medical history, giving rise to possible misdiagnosis. Cerebral ischemic stroke is the most common neurologic manifestation associated with aortic dissection, affecting 10% - 30% of patients [1,2]. Once the patient is diagnosed as having ischemic stroke, thrombolytic or anticoagulant therapy may be started before the true cause of stoke is determined. We treated a case of aortic dissection, who suffered hemiparesis and was transferred for the treatment of stroke. CT angiography showed aortic dissection extended to the bilateral common carotid arteries (CCAs). We report the case and the reports on cerebral ischemia due to the aortic dissection were reviewed.
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