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KMID : 1130620090050010049
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Journal of Clinical Neurology
2009 Volume.5 No. 1 p.49 ~ p.52
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Intravenous Recombinant Tissue Plasminogen Activator Thrombolysis in a Patient with Acute Ischemic Stroke Secondary to Aortic Dissection
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Hong Keun-Sik
Kim Chang-Young
Park So-Young
Lee Dong-Ha
Kim Han-Joon
Cho Joong-Yang
Seo So-Young
Cho Yong-Jin
Whang Seon-Il
Jang Woo-Ik
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Abstract
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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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KEYWORD
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aortic dissection, ischemic stroke, thrombolysis, recombinant tissue plasminogen
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