Chen SQ, Luo WL, Liu W, Wang LZ. Beware of the DeBakey type I aortic dissection hidden by ischemic stroke: Two case reports. World J Clin Cases 2022; 10(24): 8673-8678 [PMID: 36157827 DOI: 10.12998/wjcc.v10.i24.8673]
Corresponding Author of This Article
Wei-Liang Luo, MD, Chief Doctor, Department of Neurology, Huizhou Central People's Hospital, No. 41 Eling North Road, Huizhou 516001, Guangdong Province, China. lwl306@126.com
Research Domain of This Article
Clinical Neurology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Aug 26, 2022; 10(24): 8673-8678 Published online Aug 26, 2022. doi: 10.12998/wjcc.v10.i24.8673
Beware of the DeBakey type I aortic dissection hidden by ischemic stroke: Two case reports
Su-Qin Chen, Wei-Liang Luo, Wu Liu, Li-Zhi Wang
Su-Qin Chen, Wei-Liang Luo, Wu Liu, Li-Zhi Wang, Department of Neurology, Huizhou Central People's Hospital, Huizhou 516001, Guangdong Province, China
Author contributions: Chen SQ and Luo WL contributed to manuscript writing and editing; Luo WL contributed to conceptualization and supervision; Liu W and Wang LZ contributed to data collection and data analysis; All authors have read and approved the final manuscript.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wei-Liang Luo, MD, Chief Doctor, Department of Neurology, Huizhou Central People's Hospital, No. 41 Eling North Road, Huizhou 516001, Guangdong Province, China. lwl306@126.com
Received: February 12, 2022 Peer-review started: February 12, 2022 First decision: May 30, 2022 Revised: June 13, 2022 Accepted: July 22, 2022 Article in press: July 22, 2022 Published online: August 26, 2022 Processing time: 184 Days and 16.2 Hours
Abstract
BACKGROUND
DeBakey type I aortic dissection is one of the rare etiologies of ischemic stroke. It is critical to identify arterial dissection before intravenous thrombolysis; otherwise, fatal hemorrhage may occur.
CASE SUMMARY
In this report, we described 2 painless DeBakey type I aortic dissection cases with initial symptoms similar to ischemic stroke. Sudden onset of conscious disturbance and limb weakness within minutes occurred in both cases. Hypotension was found in both cases. Thoracoabdominal computed tomography angiography was urgently performed due to unknown reason hypotension, and DeBakey type I aortic dissection was confirmed. Intravenous thrombolysis was avoided because of timely diagnosis; however, they both eventually died of ruptured aortic dissection.
CONCLUSION
Aortic dissection should always be excluded in ischemic stroke patients with unexplained hypotension or shock symptoms before intravenous thrombolytic therapy.
Core Tip: Aortic dissection should always be excluded in ischemic patients with unexplained hypotension or shock symptoms before intravenous thrombolytic therapy. These two painless DeBakey Type I aortic dissection cases with initial symptoms similar to ischemic stroke intravenous thrombolysis was avoided because of timely diagnosis.
