E Folgoas1, F Toulgoat, M Sévin, C Boutoleau-Bretonnière, B Guillon. 1. Unité neurovasculaire, service de neurologie, hôpital G-&-R-Laënnec, centre hospitalier et universitaire de Nantes, boulevard Jacques-Monod, 44093 Nantes cedex 1, France. emmanuelle-folgoas@wanadoo.fr
Abstract
INTRODUCTION: Acute aortic dissection involving the cervical arteries often induces cerebral infarction. In this context, there is a high risk of hemorrhage and thrombolytics are contra-indicated. OBSERVATION: We report two patients with a cerebral infarction which occurred after a pauci-symptomatic and undiagnosed aortic dissection treated with thrombolysis. The outcome was poor for both patients. DISCUSSION: Ischemic strokes related to acute aortic dissection often involve the right carotid artery territory and may manifest without pain. A systematic assessment of supra-aortic arteries might help to identify the underlying diagnosis. CONCLUSION: Acute aortic dissection should be systematically mentioned in the management of the acute ischemic stroke.
INTRODUCTION: Acute aortic dissection involving the cervical arteries often induces cerebral infarction. In this context, there is a high risk of hemorrhage and thrombolytics are contra-indicated. OBSERVATION: We report two patients with a cerebral infarction which occurred after a pauci-symptomatic and undiagnosed aortic dissection treated with thrombolysis. The outcome was poor for both patients. DISCUSSION: Ischemic strokes related to acute aortic dissection often involve the right carotid artery territory and may manifest without pain. A systematic assessment of supra-aortic arteries might help to identify the underlying diagnosis. CONCLUSION: Acute aortic dissection should be systematically mentioned in the management of the acute ischemic stroke.