A case report: Efficacy of thoracic MRA for ischemic stroke due to acute aortic dissection

IF 1.5 Q2 MEDICINE, GENERAL & INTERNAL

Acute Medicine & Surgery Pub Date : 2025-05-19 DOI:10.1002/ams2.70066

Jun Nagayama, Kenji Fujizuka, Shioya Hayato, Ryosuke Tsuchiya, Mitsunobu Nakamura

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Abstract

Background

Ischemic stroke requires prompt diagnosis and treatment but rarely results from acute aortic dissection. The administration of tissue-type plasminogen activator (t-PA) to such patients can lead to serious complications and potentially fatal outcomes. Here, we report a case in which thoracic magnetic resonance angiography (MRA) was useful for identifying cerebral infarction complicated by acute aortic dissection.

Case Presentation

A 60-year-old man presented with a sudden onset of left-sided hemiplegia, right-sided hemiparesis, and dysarthria. Noncontrast CT ruled out intracranial hemorrhage; however, aortic dissection was not detected. MRI showed reduced blood flow in the right middle cerebral artery, and t-PA administration was suspected to have caused ischemic stroke. However, thoracic MRA revealed dissection from the ascending aorta to the arch, which was diagnosed using contrast-enhanced CT.

Conclusion

Thoracic MRA is useful for diagnosing acute aortic dissection in patients with a stroke.

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1例报告：胸部MRA对急性主动脉夹层缺血性脑卒中的疗效

背景缺血性脑卒中需要及时诊断和治疗，但很少由急性主动脉夹层引起。组织型纤溶酶原激活剂（t-PA）可导致严重的并发症和潜在的致命后果。在此，我们报告一例胸部磁共振血管造影（MRA）对识别脑梗死合并急性主动脉夹层是有用的。60岁男性，突然出现左侧偏瘫、右侧偏瘫和构音障碍。CT造影排除颅内出血；但未发现主动脉夹层。MRI显示右侧大脑中动脉血流减少，怀疑t-PA给药引起缺血性脑卒中。然而，胸部MRA显示从升主动脉到弓的夹层，使用增强CT诊断。结论胸部MRA对脑卒中患者急性主动脉夹层的诊断有一定价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acute Medicine & Surgery MEDICINE, GENERAL & INTERNAL-

自引率

12.50%

发文量

审稿时长

53 weeks