Successful Delayed Aortic Surgery for a Patient with Ischemic Stroke Secondary to Aortic Dissection

The diagnosis of aortic dissection (AD) is sometimes difficult within the limited time window of recombinant tissue plasminogen activator (tPA) for ischemic stroke (IS). A 60-year-old man developed sudden left hemiparesis due to IS. During tPA infusion, his blood pressure dropped and consciousness d...

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Detalles Bibliográficos
Autores principales: Morihara, Ryuta, Yamashita, Toru, Deguchi, Kentaro, Tsunoda, Keiichiro, Manabe, Yasuhiro, Takahashi, Yoshiaki, Yunoki, Taijun, Sato, Kota, Nakano, Yumiko, Kono, Syoichiro, Ohta, Yasuyuki, Hishikawa, Nozomi, Abe, Koji
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2017
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5635312/
https://www.ncbi.nlm.nih.gov/pubmed/28794365
http://dx.doi.org/10.2169/internalmedicine.8438-16
Descripción
Sumario:The diagnosis of aortic dissection (AD) is sometimes difficult within the limited time window of recombinant tissue plasminogen activator (tPA) for ischemic stroke (IS). A 60-year-old man developed sudden left hemiparesis due to IS. During tPA infusion, his blood pressure dropped and consciousness declined. After transfer to our hospital, carotid duplex ultrasonography led to a diagnosis of AD. Emergency surgery was postponed because of the risk of hemorrhagic transformation. The patient successfully underwent aortic surgery on day 5 and was discharged with a remarkable improvement in his symptoms. Delayed surgery may avoid hemorrhagic transformation in patients with AD-induced IS who have received tPA.

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