Journal of clinical neurology

Korean Neurological Association (대한신경과학회)
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Intravenous Recombinant Tissue Plasminogen Activator Thrombolysis in a Patient with Acute Ischemic Stroke Secondary to Aortic Dissection

Hong, Keun-Sik;Park, So-Young;Whang, Seon-Il;Seo, So-Young;Lee, Dong-Ha;Kim, Han-Joon;Cho, Joong-Yang;Cho, Yong-Jin;Jang, Woo-Ik;Kim, Chang-Young

  • Published : 20090300
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Abstract

Background Acute ischemic stroke secondary to aortic dissection (AoD) is challenging in the era of thrombolysis owing to the diagnostic difficulty within a narrow time window and the high risk of complications. Case Report A 64-year-old woman with middle cerebral artery occlusion syndrome admitted to the emergency room within intravenous recombinant tissue plasminogen activator (rt-PA) time window. Her neurological symptoms improved during thrombolysis, but chest and abdominal pain developed. Repeated history-taking, physical examination, and imaging studies led to the timely diagnosis and surgical treatment of AoD, which produced a successful outcome. Conclusions Clinical suspicion is invaluable for the diagnosis of this rare cause of stroke. Considering the stroke mechanism and complications, the risks of thrombolysis might outweigh its benefits.

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References

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