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A patient with acute aortic dissection presenting with bilateral stroke – A rare experience
Affiliations- Department of Neurology, Ministry of Interior Hospital, Krakow, Poland
- Collegium Medicum of Jagiellonian University, Department of Cardiac and Vascular Diseases, John Paul II Hospital, Kraków, Poland, ul.Prądnicka 80, 31-202 Cracow, Poland
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Abstract
Acute aortic dissection is a rare, life-threatening condition requiring early recognition and proper treatment. Although chest pain remains the most frequent initial symptom, clinical manifestation of aortic dissection varies. Rarely aortic dissection starts with neurological symptoms such as ischemic stroke, which is usually right-sided. A danger of performing thrombolytic therapy in these patients exists if aortic dissection is overlooked. Herein, we present a case of a patient with acute aortic dissection without typical chest pain whose initial manifestation was bilateral stroke. The uncommon presentation which masked the underlying condition delayed implementation of appropriate management. Moreover, the late admission to hospital prevented the patient from administration of recombined tissue plasminogen activator that would certainly decrease chances of survival. Presented case highlights the need for thorough physical examination at admission to hospital in all patients with acute stroke and points out the necessity of proper clinical work-up including adequate aorta imaging modalities of patients with acute stroke and suggestive findings of aortic dissection.
Abstract
Acute aortic dissection is a rare, life-threatening condition requiring early recognition and proper treatment. Although chest pain remains the most frequent initial symptom, clinical manifestation of aortic dissection varies. Rarely aortic dissection starts with neurological symptoms such as ischemic stroke, which is usually right-sided. A danger of performing thrombolytic therapy in these patients exists if aortic dissection is overlooked. Herein, we present a case of a patient with acute aortic dissection without typical chest pain whose initial manifestation was bilateral stroke. The uncommon presentation which masked the underlying condition delayed implementation of appropriate management. Moreover, the late admission to hospital prevented the patient from administration of recombined tissue plasminogen activator that would certainly decrease chances of survival. Presented case highlights the need for thorough physical examination at admission to hospital in all patients with acute stroke and points out the necessity of proper clinical work-up including adequate aorta imaging modalities of patients with acute stroke and suggestive findings of aortic dissection.
Keywords
Aortic dissection, Stroke, Neurological symptoms, Thrombolytic therapy
About this articleTitle
A patient with acute aortic dissection presenting with bilateral stroke – A rare experience
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
197-202
Page views
259
Article views/downloads
449
DOI
10.1016/j.pjnns.2015.04.009
Bibliographic record
Neurol Neurochir Pol 2015;49(3):197-202.
Keywords
Aortic dissection
Stroke
Neurological symptoms
Thrombolytic therapy
Authors
Olimpia Kowalska-Brozda
Mateusz Brozda
