• Rev Neurol France · Apr 2012

    Review Case Reports

    [Ischemic stroke related to pauci-symptomatic acute aortic dissection. Risks of intravenous thrombolysis].

    • E Folgoas, F Toulgoat, M Sévin, C Boutoleau-Bretonnière, and B Guillon.
    • Unité neurovasculaire, service de neurologie, hôpital G-&-R-Laënnec, centre hospitalier et universitaire de Nantes, boulevard Jacques-Monod, 44093 Nantes cedex 1, France. emmanuelle-folgoas@wanadoo.fr
    • Rev Neurol France. 2012 Apr 1;168(4):357-62.

    IntroductionAcute aortic dissection involving the cervical arteries often induces cerebral infarction. In this context, there is a high risk of hemorrhage and thrombolytics are contra-indicated.ObservationWe report two patients with a cerebral infarction which occurred after a pauci-symptomatic and undiagnosed aortic dissection treated with thrombolysis. The outcome was poor for both patients.DiscussionIschemic strokes related to acute aortic dissection often involve the right carotid artery territory and may manifest without pain. A systematic assessment of supra-aortic arteries might help to identify the underlying diagnosis.ConclusionAcute aortic dissection should be systematically mentioned in the management of the acute ischemic stroke.Copyright © 2012 Elsevier Masson SAS. All rights reserved.

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