Use of recombinant tissue plasminogen activator (rt-PA) for the treatment of acute cerebral infarction secondary to aortic dissection is challenging because of a narrow time window and potential life-threatening complications. An 80-year-old woman with right middle cerebral artery infarction was treated with rt-PA. Although she had no history, symptoms, or sign of aortic dissection, carotid CT angiography revealed aortic arch dissection. Mediastinal widening, which did not show on initial chest X-ray, developed on follow-up chest X-ray. This observation indicates that physicians should monitor patient symptoms for signs of aortic dissection during thrombolysis and perform chest X-ray or carotid angiography immediately after thrombolysis even if the patient has no symptoms or signs of aortic dissection on onset of acute cerebral infarction.

Citations

Citations to this article as recorded by  

• Successful intravenous thrombolysis for acute ischemic stroke caused by aortic dissection with severe hypofibrinogenemia: a case report and literature review
  Liming Cao, Xuming Huang, Fei-qi Zui
  International Journal of Neuroscience.2022; 132(9): 939.     CrossRef
• Clinical Usefulness of Common Carotid Artery Dissection in Carotid Ultrasound for the Diagnosis of Asymptomatic Aortic Dissection
  Seon-Jae Im, Hyun Young Park
  Journal of the Korean Neurological Association.2020; 38(1): 66.     CrossRef