A 68-year-old man lost consciousness while speaking. Computed tomography of the head revealed no hemorrhage or areas of hypodensity. Recombinant tissue plasminogen activator was administered. Neck duplex scanning showed dissecting intima of the right common carotid artery. Chest computed tomography disclosed Stanford type A aortic dissection. We performed emergency surgery because the right common carotid artery was severely stenosed. Despite 8 h of surgery due to coagulopathy, the patient was discharged without neurological deficits.
YamaguchiTMoriEMinematsuK. Alteplase at 0.6 mg/kg for acute ischemic stroke within 3 hours of onset. Japan alteplase clinical trial (J-ACT). Stroke2006; 37: 1810–1815.
2.
Veyssier-BelotCCohenARougemontDLevyCAmarencoPBousserMG. Cerebral infarction due to painless thoracic aortic and common carotid artery dissections. Stroke1993; 24: 2111–2113.
3.
NoelMShortJFarooqMU. Thrombolytic therapy in a patient with acute ischemic stroke caused by aortic dissection. Clin Neurol Neurosurg2010; 112: 695–696.
4.
MertensDHerregodsMCVan De WerfF. Thrombolytic therapy and acute aortic dissection. Acta Cardiol1992; 5: 501–505.
5.
FesslerAJAlbertsMJ. Stroke treatment with tissue plasminogen activator in the setting of aortic dissection. Neurology2000; 54: 1010–1011.
6.
ChuaCHLienLMLinCHHungCR. Emergency surgical intervention in a patient with delayed diagnosis of aortic dissection presenting with acute ischemic stroke and undergoing thrombolytic therapy. J Thorac Cardiovasc Surg2005; 130: 1222–1224.
7.
UchinoKEstreraACallejaSAlexandrovAVGaramiZ. Aortic dissection presenting as an acute ischemic stroke for thrombolysis. J Neuroimaging2005; 15: 281–283.
8.
RylskiBSiepeMBlankePEuringerWSchoellhornJBeyersdorfF. Adventitial inversion with graft telescopic insertion for distal anastomosis in acute type A aortic dissection. Ann Thorac Cardiovasc Surg2012; 18: 278–280.
