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Putamen hemorrhage occurred simultaneously with Stanford type A acute aortic dissection: a case report
Tomohiro Sonoo1, Tomoki Wada, Ryota Inokuchi
1Department of Emergency Medicine and Critical care, University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan. sonopy77@yahoo.co.jp
The American Journal of Emergency Medicine
|May 18, 2013
Summary
This case report highlights a rare instance of simultaneous brain hemorrhage and acute aortic dissection. Early suspicion and investigation of aortic dissection are crucial in patients with altered consciousness due to brain hemorrhage.
Area of Science:
- Neurology
- Cardiovascular Medicine
- Emergency Medicine
Background:
- Simultaneous occurrence of spontaneous intracranial hemorrhage and acute aortic dissection is rare.
- Both conditions share common risk factors like hypertension and atherosclerosis.
- Prompt diagnosis of acute aortic dissection can be challenging in patients with altered mental status.
Observation:
- A 60-year-old male presented with unresponsiveness, consciousness disturbance, and decorticate rigidity.
- Computed tomography revealed left putamen hemorrhage and Stanford type A acute aortic dissection.
- Autopsy confirmed extensive aortic dissection and significant pericardial effusion.
Findings:
- The patient underwent decompressive craniectomy and hematoma evacuation but demised on hospital day two.
- The coexistence of brain hemorrhage and acute aortic dissection presents diagnostic challenges in emergency settings.
- This case underscores the importance of considering aortic dissection in patients with intracranial hemorrhage.
Implications:
- Increased awareness is needed among clinicians to suspect and investigate acute aortic dissection in patients presenting with brain hemorrhage.
- Early recognition and management of acute aortic dissection can potentially improve patient outcomes.
- This case contributes to the limited literature on the simultaneous presentation of these two critical conditions.
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