Abstract
We describe a 59-year-old woman with cerebral infarction and acute aortic dissection who underwent cerebral decompression followed by elective arch replacement. The patient was admitted to a nearby hospital with minimal tongue movement and suspected right brain infarction. Chest CT on the following day confirmed acute type A aortic dissection and a right common carotid artery which occluded. Depressed consciousness and anisocoria became evident at two days after onset, when she was transferred to our hospital. At that time, Brain CT showed a midline shift and pressure on the brainstem. Emergency right front temporal craniectomy with internal and external decompression at three days after onset was followed by arch replacement for the Type A aortic dissection at 46 days after onset. Left hemiplegia that was evident before arch replacement did not improve, but the right half of the body recovered. The patient was transferred to another hospital to undergo rehabilitation at 118 days after onset.
