Related Experiment Videos
Aortic dissection presenting as an acute ischemic stroke for thrombolysis
Ken Uchino1, Anthony Estrera, Sergio Calleja
1Department of Neurology, University of Texas-Houston Medical School, Houston, TX, USA. uchinok@upmc.edu
Summary
Emergent ultrasonography aids in diagnosing aortic dissection presenting as acute ischemic stroke. This imaging technique can alter treatment plans for stroke patients, improving outcomes.
Area of Science:
- Neurology
- Cardiology
- Radiology
Background:
- Acute ischemic stroke treatment necessitates precise patient selection.
- Aortic dissection is a rare but critical diagnosis that can mimic stroke symptoms.
Observation:
- A patient presented with acute middle cerebral artery ischemic stroke symptoms and chest pain.
- Initial tests including chest x-ray, cardiac enzymes, and echocardiogram were unremarkable.
- Carotid ultrasound revealed right common carotid occlusion, suggesting an alternative diagnosis.
Findings:
- The carotid ultrasound finding led to the diagnosis of aortic dissection, confirmed by CT scan.
- Ultrasonography proved crucial in identifying the underlying cause of the ischemic stroke.
- Rapid intra- and extracranial ultrasound examinations by skilled sonographers can impact acute stroke management.
Implications:
- Ultrasonography can be a valuable, rapid diagnostic tool in acute stroke cases with atypical presentations.
- Early diagnosis of aortic dissection in stroke patients allows for timely and appropriate intervention.
- This case highlights the importance of considering vascular emergencies beyond typical stroke etiologies.