J Med Assoc Thai 2008; 91 (8):1302

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Type A Aortic Dissection Presenting as Acute Ischemic Stroke Caution for Thrombolytic Therapy: A Case Report and Literatures Review
Ngernsritrakul T Mail, Sathirapanya P

The authors reported a patient who had type A aortic dissection presenting with sudden onset of
right hemiplegia and depressed consciousness. CT scan of brain showed acute cerebral infarction of left
corona radiata, posterior limb of left internal capsule combined with left hemispheric brain swelling. An old
cerebral infarction at the posterior limb of right internal capsule was also noted. Clinical signs of aortic
regurgitation and difference in blood pressures and amplitude of pulses on both arms were associated. Initial
chest x-ray revealed widening of the mediastinum. CT scan of chest revealed dissecting aorta extending from
the ascending aorta to the mid of the descending aorta. Surgical correction of the aorta was refused and the
patient was treated medically with partial neurological deficit. No additional cardiovascular events occurred.

Keywords: Aortic dissection, Ischemic stroke, Thrombolytic therapy


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