Case Report: Ischemic Stroke As a Result of Aortic Dissection

A cute aortic dissection is a life-threatening condition that requires urgent evaluation and treatment.Its incidence varies from 2.9-4.7 cases per 100,000 people annually [1,2] .According to one of the latest studies, 17.6% of acute aortic dissection patients died before hospital arrival [3] .Aortic dissection is painless in approximately 5-10% of patients [4] .Most of those are with neurologic complications. Case ReportA 47-year-old male with no known chronic disease was admitted to the emergency department (ED) suffering from loss of consciousness.The patient had a sudden-onset right-sided weakness.Since then, he was unresponsive.On his physical examination, the Glasgow Coma Scale score was 3. His right eye deviated to the left side.His blood pressure (BP) was 125/58 mmHg and his heart rate was 74 bpm.Peripheral oxygen saturation was 88%, and he had gasping respiration.A computed tomography (CT) scan of the brain and thorax was arranged.There was no intracranial bleeding.After that, diffusion magnetic resonance imaging (MRI) was performed, which disclosed acute cerebral infarction in the left cerebral hemisphere (Fig. 1).Cranial and cervical computed tomography angiography (CTA) was performed, and we planned to refer the patient to a thrombectomy unit.We noticed that he had aortic dissection in the arcus aorta and right common carotid artery (CCA) and blockage of the left CCA and brachiocephalic trunk with thrombus.Then, thorax and abdominal CTA were performed and showed dissection starting from the aortic root to the iliac arteries, including the right iliac artery.There was no need for thrombectomy due to revascularization of the left CCA (Figs. 2,3).Stroke is one of the leading causes of mortality and morbidity.Aortic dissection is a highly mortal medical condition without treatment as well.Aortic dissection can present with different clinical signs and symptoms, one of which is stroke.Treatments of ischemic stroke and aortic dissection are different from each other.Because of that, early diagnosis and treatment of ischemic stroke due to aortic dissection is important.In this case, we aimed to explain a young male patient with a large ischemic stroke as a result of painless dissection and thrombus of the carotid arteries and painless dissection of the ascending and descending aorta, arcus aorta, and iliac artery.