VOLUME 3 , ISSUE 6 ( November-December, 2024 ) > List of Articles
Raghavendra Deshpande, Rajavardhan Rangappa, Narayana S Moola, Sanjana Anand
Keywords : Acute ischemic stroke, Aortic dissection, Case report, Ischemic infarct, Thrombolysis
Citation Information : Deshpande R, Rangappa R, Moola NS, Anand S. Aortic Dissection Masquerading as a Stroke. 2024; 3 (6):169-171.
DOI: 10.5005/jp-journals-11006-0126
License: CC BY-NC 4.0
Published Online: 19-10-2024
Copyright Statement: Copyright © 2024; The Author(s).
Aim and background: Aortic dissection is a life-threatening condition, it is a recognised cause of acute ischemic stroke. Aortic dissection is a contraindication to thrombolysis with recombinant tissue plasminogen activator (rt-PA). Consequently, the exclusion of aortic dissection is imperative before initiating anticoagulants or thrombolysis. Case description: We present a case of a 58-year-old female presented to the hospital with complaints of decreased responsiveness and giddiness at home. She was put on mechanical ventilator due to low GCS (Glasgow coma scale). Initial CT was normal, she was shifted to the ICU for further management. Later the same day of admission, she was noted to have right sided paucity of movement, MRI done showed acute infarcts in bilateral posterior and left anterior watershed zones suspicious of hemorrhagic transformation, flair intensity mismatch was not seen. Her ECHO showed septal hypokinesia and aortic regurgitation and a flap like structure, aortic dissection which was later confirmed by carotid Doppler and CT aortogram: showed Stanford A type of aortic dissection. The same day, she underwent ascending aorta and hemiarch replacement. Eventually discharged on day 17th of admission with minimal neurological deficit. Conclusion: Thrombolysis stands as a cornerstone in the management of acute ischemic stroke; however, the oversight of concurrent aortic dissection could gravely escalate both mortality and morbidity. Clinical significance: In the case presented, a vigilant clinical evaluation, complemented by prompt imaging and bedside echocardiography, was pivotal in the post hoc diagnosis of aortic dissection. This timely intervention was instrumental in steering an early therapeutic course, culminating in a positive patient prognosis.