Hama Yuka, Koga Masatoshi, Tokunaga Keisuke, Takizawa Hotake, Miyashita Kotaro, Iba Yutaka, Toyoda Kazunori
Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Suita, Japan.
Division of Stroke Care Unit, National Cerebral and Cardiovascular Center, Osaka, Suita, Japan.
J Neuroimaging. 2015 Jul-Aug;25(4):671-3. doi: 10.1111/jon.12186. Epub 2014 Dec 16.
Acute aortic dissection is the most common acute aortic condition requiring urgent surgical therapy. Due to lack of typical symptoms, it is sometimes difficult to identify acute aortic dissection causing ischemic stroke. We report a case of a patient with acute ischemic stroke who was deemed ineligible for intravenous recombinant tissue plasminogen activator treatment based on a finding of acute aortic dissection detected by carotid ultrasonography. After urgent aortic replacement surgery, the patient recovered with no neurological deficit. This case underscores the crucial role of carotid ultrasonography for the investigation of possible underlying acute aortic dissection when considering the use of intravenous recombinant tissue plasminogen activator therapy for hyperacute stroke.
急性主动脉夹层是最常见的需要紧急手术治疗的急性主动脉疾病。由于缺乏典型症状，有时难以识别导致缺血性卒中的急性主动脉夹层。我们报告一例急性缺血性卒中患者，根据颈动脉超声检查发现的急性主动脉夹层，该患者被认为不符合静脉注射重组组织型纤溶酶原激活剂治疗的条件。紧急主动脉置换手术后，患者康复且无神经功能缺损。该病例强调了在考虑对超急性卒中使用静脉注射重组组织型纤溶酶原激活剂治疗时，颈动脉超声检查对于调查可能潜在的急性主动脉夹层的关键作用。
