Stroke Presentation of Acute Type A Aortic Dissection with 100% Perfusion-Weighted Imaging-Diffusion-Weighted Imaging Mismatch: A Call for Urgent Action.
J Stroke Cerebrovasc Dis
; 25(5): 1280-1283, 2016 May.
Article
em En
| MEDLINE
| ID: mdl-26965469
ABSTRACT
BACKGROUND AND PURPOSE:
Acute stroke in the setting of acute type A aortic dissection is not rare and may contraindicate immediate surgery. Evaluating irreversible brain damage is critical in this setting and magnetic resonance imaging is a key determinant in the decision of selecting surgical over medical treatment for these patients. SUMMARY OF CASES We report herein 2 cases assessed at a tertiary care center for acute stroke. The initial diagnosis workup revealed cerebral hemispheric severe hypoperfusion without any brain infarction. The absence of ischemic lesions prompted surgical repair, despite the severity of clinical symptoms. Both patients demonstrated complete neurological recovery and neuroimaging showed no persistent sequel.CONCLUSION:
Acute type A aortic dissection is an important differential diagnosis in the causative workup for stroke. Brain hypoperfusion alone should not be a contraindication for urgent surgical treatment, regardless of initial clinical neurological severity.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Aneurisma Aórtico
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Isquemia Encefálica
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Circulação Cerebrovascular
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Estenose das Carótidas
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Acidente Vascular Cerebral
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Imagem de Difusão por Ressonância Magnética
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Dissecção Aórtica
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Prognostic_studies
Limite:
Aged
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Female
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Humans
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article