Affiliated Bayi Brain Hospital, The Seventh Medical Center of PLA General Hospital, Beijing, China.
Neurol India. 2020 Jan-Feb;68(1):185-188. doi: 10.4103/0028-3886.279679.
Acute aortic dissection (AAD) complicated with acute cerebral infarction lacks a unified treatment plan. We report probably the most effective treatment of a type A AAD with acute cerebral infarction leading to coma. A 43-year-old man presented with acute hemiplegia and unconsciousness. He was diagnosed as acute cerebral infarction. After an ineffective emergency intravenous thrombolysis, a Digital Subtraction Angiography (DSA) examination revealed the severe cerebral artery occlusion, and the TICI 3 level was achieved by stent implantation in the left common carotid artery with significant neurological recovery. A type A AAD was found at the 1 month follow-up ultrasound examination and a further thoracic surgery was performed successfully. Carotid ultrasound is helpful for the diagnosis of AAD from acute cerebral infarction. Carotid artery stenting followed by thoracic surgery is effective in this kind of emergency situations. Further studies are needed to determine the exact indications.
急性主动脉夹层（AAD）合并急性脑梗死缺乏统一的治疗方案。我们报告了一种可能是最有效的治疗方法，用于治疗导致昏迷的 A 型 AAD 合并急性脑梗死。一名 43 岁男性因急性偏瘫和意识丧失就诊。他被诊断为急性脑梗死。在无效的紧急静脉溶栓治疗后，数字减影血管造影（DSA）检查显示严重的大脑动脉闭塞，通过左颈总动脉支架植入术达到 TICI 3 级，神经功能显著恢复。在 1 个月的超声随访中发现了 A 型 AAD，并成功进行了进一步的胸部手术。颈动脉超声有助于从急性脑梗死中诊断 AAD。颈动脉支架置入术后继发的胸部手术在这种紧急情况下是有效的。需要进一步的研究来确定确切的适应证。
