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

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  • Morihara Ryuta
    Departments of Neurology, Dentistry, and Pharmaceutical Sciences, Graduate School of Medicine, Okayama University, Japan
  • Yamashita Toru
    Departments of Neurology, Dentistry, and Pharmaceutical Sciences, Graduate School of Medicine, Okayama University, Japan
  • Deguchi Kentaro
    Departments of Neurology, Dentistry, and Pharmaceutical Sciences, Graduate School of Medicine, Okayama University, Japan
  • Tsunoda Keiichiro
    Departments of Neurology, Dentistry, and Pharmaceutical Sciences, Graduate School of Medicine, Okayama University, Japan
  • Manabe Yasuhiro
    Department of Neurology, Okayama National Hospital Medical Center, Japan
  • Takahashi Yoshiaki
    Department of Neurology, Okayama National Hospital Medical Center, Japan
  • Yunoki Taijun
    Departments of Neurology, Dentistry, and Pharmaceutical Sciences, Graduate School of Medicine, Okayama University, Japan
  • Sato Kota
    Departments of Neurology, Dentistry, and Pharmaceutical Sciences, Graduate School of Medicine, Okayama University, Japan
  • Nakano Yumiko
    Departments of Neurology, Dentistry, and Pharmaceutical Sciences, Graduate School of Medicine, Okayama University, Japan
  • Kono Syoichiro
    Department of Neurology, Okayama National Hospital Medical Center, Japan
  • Ohta Yasuyuki
    Departments of Neurology, Dentistry, and Pharmaceutical Sciences, Graduate School of Medicine, Okayama University, Japan
  • Hishikawa Nozomi
    Departments of Neurology, Dentistry, and Pharmaceutical Sciences, Graduate School of Medicine, Okayama University, Japan
  • Abe Koji
    Departments of Neurology, Dentistry, and Pharmaceutical Sciences, Graduate School of Medicine, Okayama University, Japan

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Description

<p>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. </p>

Journal

  • Internal Medicine

    Internal Medicine 56 (17), 2343-2346, 2017

    The Japanese Society of Internal Medicine

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