Jun Nagayama, Kenji Fujizuka, Shioya Hayato, Ryosuke Tsuchiya, Mitsunobu Nakamura
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A case report: Efficacy of thoracic MRA for ischemic stroke due to acute aortic dissection
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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