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Case Reports in Emergency Medicine
Volume 2014 (2014), Article ID 468295, 4 pages
Case Report

What Lies behind the Ischemic Stroke: Aortic Dissection?

1Department of Emergency Medicine, Faculty of Medicine, Kirikkale University, 71350 Kirikkale, Turkey
2Department of Neurology, Faculty of Medicine, Kirikkale University, 71350 Kirikkale, Turkey
3Department of Cardiology, Faculty of Medicine, Kirikkale University, 71350 Kirikkale, Turkey

Received 18 October 2014; Accepted 14 November 2014; Published 2 December 2014

Academic Editor: Kazuhito Imanaka

Copyright © 2014 Turgut Deniz et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Introduction. Some cases with aortic dissection (AD) could present with various complaints other than pain, especially neurological and cardiovascular manifestations. AD involving the carotid arteries could be associated with many clinical presentations, ranging from stroke to nonspecific headache. Case Report. A 71-year-old woman was admitted to emergency department with vertigo which started within the previous one hour and progressed with deterioration of consciousness following speech disorder. On arrival, she was disoriented and uncooperative. Diffusion magnetic resonance imaging (MRI) of brain was consistent with acute ischemia in the cerebral hemisphere. Fibrinolytic treatment has been planned since symptoms started within two hours. Echocardiography has shown the dilatation of ascending aorta with a suspicion of flap. Computed tomography (CT) angiography has been applied and intimal flap has been detected which was consistent with aortic dissection, intramural hematoma of which was reaching from aortic arch to bilateral common carotid artery. Thereafter, treatment strategy has completely changed and surgical invention has been done. Conclusion. In patients who are admitted to the emergency department with the loss of consciousness and stroke, inadequacy of anamnesis and carotid artery involvement of aortic dissection should be kept in mind.