The differential diagnosis of acute ischemic stroke and acute aortic dissection in clinical characters

Abstract

Background: Hemiparesis without chest pain could make it complicate to distinguish acute aortic dissection (AAD) and ischemic stroke. We, therefore, investigated the clinical characters in patients with these diseases.Methods: In 334 consecutive patients with ischemic stroke, including cerebral infarction and transient ischemic attack, and 38 patients with stanford type A AAD, we retrospectively analyzed their vital signs, D-dimer, chest radiographs, and the filming conditions at initial visit.Results: Eight patients had AAD with hemiparesis. Compared to patients with ischemic stroke, they showed significant low blood pressure, elevation of D-dimer, and widening of mediastinum on chest radiograph, with or without hemiparesis.Conclusion: Blood pressure, D-dimer, and chest radiograph can be useful to distinguish between AAD and ischemic stroke.