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Stanford type a aortic dissection with cerebral infarction: a rare case report
Jie Wang1, Li-Rong Wu2, Xin Xie2
1Department of Neurology, Chongqing City Hospital of Traditional Chinese Medicine, No. 6, Seventh Branch Road, Panxi, Jiangbei District, Chong qing, 400021, China. 870113579@qq.com.
BMC Neurology
|June 25, 2020
Summary
A rare case of aortic dissection (AoD) presented with atypical neurological symptoms like epilepsy due to cerebral ischemia. Early surgical intervention is crucial for AoD with stroke, as thrombolysis is contraindicated.
Area of Science:
- Neurology
- Cardiovascular Surgery
- Radiology
Background:
- Aortic dissection (AoD) is a life-threatening condition with diverse and often subtle clinical presentations.
- Prompt diagnosis and treatment are critical due to AoD's high mortality rate.
Observation:
- A 54-year-old male with hypertension and substance use presented with acute stroke symptoms (aphasia, hemiplegia).
- During thrombolysis, he developed epilepsy, prompting further investigation.
- CT angiography revealed extensive aortic dissection involving the aorta and carotid arteries.
Findings:
- The patient experienced bilateral cerebral cortex ischemia and epilepsy secondary to aortic dissection.
- Cerebral infarction was confirmed via diffusion-weighted imaging (DWI).
Implications:
- Aortic dissection can manifest atypically with neurological deficits such as epilepsy, mimicking primary neurological events.
- Cerebral infarction secondary to AoD is a contraindication for intravenous thrombolysis.
- Surgical management is the preferred treatment for AoD complicated by cerebral infarction to improve outcomes.
