“Time is brain” captures the essence of treating acute stroke. The diagnosis must
be confidently established, whereas contraindications for thrombolysis must be excluded
in a timely manner. However, stroke mimics always pose a challenge. We describe a
case of aortic dissection presenting as right middle cerebral artery syndrome who
received intravenous thrombolysis complicated by aortic rupture with a fatal outcome.
A Medline search shows that this is the first report of aortic rupture since the inception
of thrombolysis for acute stroke. The emerging application of point-of-care carotid
ultrasonography may identify these patients before thrombolysis.
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References
- Dissection and dissecting aneurysms of the aorta: twenty-year follow-up of five hundred twenty-seven patients treated surgically.Surgery. 1982; 92: 1118-1134
- Intravenous thrombolysis in an elderly patient with acute ischemic stroke masking aortic dissection.J Stroke Cerebrovasc Dis. 2011; 20: 559-561
- Aortic arch dissection causing acute cerebral ischemia: an uncommon contraindication for intravenous thrombolysis.Circulation. 2011; 124: 657-658
- Aortic dissection complicated with fatal cerebral infarction: case report and review of literatures.Open J Mod Neurosurg. 2012; 02: 4
Article Info
Publication History
Published online: November 18, 2015
Accepted:
November 8,
2015
Received:
October 11,
2015
Footnotes
☆No funding was received to produce this work.
☆☆All authors have access to the data and role in writing this manuscript.
★We report no conflict of interests regarding this work.
Identification
Copyright
© 2015 Elsevier Inc. All rights reserved.
