Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
CASE REPORTS
Successful Delayed Aortic Surgery for a Patient with Ischemic Stroke Secondary to Aortic Dissection
Ryuta MoriharaToru YamashitaKentaro DeguchiKeiichiro TsunodaYasuhiro ManabeYoshiaki TakahashiTaijun YunokiKota SatoYumiko NakanoSyoichiro KonoYasuyuki OhtaNozomi HishikawaKoji Abe
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JOURNALS OPEN ACCESS

2017 Volume 56 Issue 17 Pages 2343-2346

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Abstract

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.

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© 2017 by The Japanese Society of Internal Medicine
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