Intravenous thrombolysis in an elderly patient with acute ischemic stroke masking aortic dissection

David Rodríguez-Luna, Rosa María Vilar, Manuel Peinazo, Ana Del Villar, Berta Claramonte, Carlos Vilar, Daniel Geffner

Producció científica: Article en revista indexadaArticleAvaluat per experts

18 Cites (Scopus)


Before thrombolytic treatment for acute ischemic stroke is undertaken, conditions associated with increased risk of hemorrhagic complications, such as an acute aortic dissection (AAD), should be excluded. We report an 80-year-old woman with acute ischemic stroke as the sole clinical manifestation of AAD who was treated with intravenous (IV) tissue plasminogen activator (tPA). She had no history of hypertension or any signs or symptoms suggestive of AAD. After IV tPA infusion was started, carotid color-coded duplex sonography demonstrated proximal left common carotid artery dissection suggestive of AAD. Infusion of tPA was stopped, and subsequent computed tomography angiography confirmed Stanford type A aortic dissection. In this case, prompt neurosonologic evaluation helped us make an appropriate diagnosis and avoid complications related to treatment. Neurosonologic evaluation should be considered as soon as possible in all patients with acute ischemic stroke, especially when thrombolytic treatment is being considered.

Idioma originalAnglès
Pàgines (de-a)559-561
Nombre de pàgines3
RevistaJournal of Stroke and Cerebrovascular Diseases
Estat de la publicacióPublicada - de nov. 2011
Publicat externament


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