Aortic dissection with cerebral infarction

Aortic dissection is a fatal cardiovascular health problem. Chest and back pain are among the common complaints of the patients, and they may also apply with atypical clinics. It is very difficult to diagnose with examination and anamnesis, especially in patients who present with poor consciousness and stroke symptoms. In this study, we wanted to present a 62-year-old female patient who had syncope at home and was unconscious for about 1 hour, has stroke symptoms, and aortic dissection was detected in her examinations. When no hemorrhage was detected in non-contrast brain CT, neck and brain contrast-enhanced CT angiography imaging was performed. Aortic dissection flap extending to the right carotid communis was detected in the imaging. Clinicians should pay attention to detailed examination and be alert for further examinations in order not to harm the patient in terms of underlying causes, especially in unconscious patients who have a stroke clinic and cannot express their complaints in a healthy way.

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  • Bossone, Eduardo, et al. "Stroke and outcomes in patients with acute type A aortic dissection." Circulation 128.11_suppl_1 (2013): S175-S179.
  • Doroghazi, Robert M., et al. "Long-term survival of patients with treated aortic dissection." Journal of the American College of Cardiology 3.4 (1984): 1026-1034.
  • Ehrlich, Marek P., et al. "Results of immediate surgical treatment of all acute type A dissections." Circulation 102.suppl_3 (2000): Iii-248.
  • Gaul, Charly, Wenke Dietrich, and Frank Joachim Erbguth. "Neurological symptoms in aortic dissection: a challenge for neurologists." Cerebrovascular Diseases 26.1 (2008): 1-8.
  • Gaul, Charly, et al. "Neurological symptoms in type A aortic dissections." Stroke 38.2 (2007): 292-297.
  • Guglielmi, Valeria, Nina Suzanne Groeneveld, Laura Posthuma, Adrien E. Groot, Charles B. L. M. Majoie, Hanna Talacua, Abdullah Kaya, S. Matthijs Boekholdt, R. Nils Planken, Yvo Bwem Roos, and Jonathan M. Coutinho. 2020. “Aortic Dissection Masquerading as a Code Stroke: A Single-Centre Cohort Study.” European Stroke Journal 5(1):56–62. doi: 10.1177/2396987319883713.
  • Minematsu, Kazuo, et al. "Guidelines for the intravenous application of recombinant tissue-type plasminogen activator (alteplase), the second edition, October 2012: a guideline from the Japan Stroke Society." Journal of Stroke and Cerebrovascular Diseases 22.5 (2013): 571-600.
  • Pansini, Stefano, et al. "Early and late risk factors in surgical treatment of acute type A aortic dissection." The Annals of thoracic surgery 66.3 (1998): 779-784.
  • Sakamoto, Yuki, et al. "Frequency and detection of Stanford type A aortic dissection in hyperacute stroke management." Cerebrovascular Diseases 42.1-2 (2016): 110-116.
  • Tsai, Thomas T., et al. "Partial thrombosis of the false lumen in patients with acute type B aortic dissection." New England Journal of Medicine 357.4 (2007): 349-359.
  • Ueyama, Keishi, et al. "Urgent simultaneous revascularization of the carotid artery and ascending aortic replacement for type A acute aortic dissection with cerebral malperfusion." General thoracic and cardiovascular surgery 55.7 (2007): 284-286.