Abstract
A post-marketing surveillance study reported fatalities following tissue plasminogen activator administration among acute cerebral infarction patients with acute aortic dissection (AAD). Acute physicians must distinguish between acute cerebral infarction and AAD in the emergency room. To distinguish these diseases, oral consultation a regarding pain and chest X-ray and ultrasound examination should be performed. However, it is difficult to distinguish AAD and acute cerebral infarction by these means alone. We experienced four patients with acute cerebral infarction with AAD. From these experiences, we considered diagnostic methods for AAD in patients with cerebral infarction. In all four patients, blood test results upon admission showed high level of fibrin/fibrinogen degradation products (FDP). Measurement of FDP may be useful for distinction between acute cerebral infarction and AAD in the emergency room.
