Key result
CT angiography successfully identified an underlying aortic dissection in a patient presenting with acute stroke symptoms, preventing the potentially fatal administration of intravenous tPA.
Case Report (n=1)
No
Aortic dissection can present as acute stroke without chest pain, and performing a CTA of the neck can prevent the potentially fatal administration of tPA.
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CTA may avert fatal tPA in aortic dissection mimicking stroke; case reports leave open whether neck CTA warrants routine use.
A 61-year-old woman with no prior medical illness presented with acute onset stroke symptoms. She had no chest pain at the time of presentation. However, CT angiogram showed an extensive aortic dissection, resulting in hypoperfusion of the right cerebral hemisphere and thus causing stroke symptoms. Due to this finding, tissue plasminogen activator was not given and a negative outcome was avoided.
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Shivkumar et al. (2019) conducted a case report in Acute stroke related to aortic dissection (n=1). Intravenous tPA (withheld) was evaluated on Patient recovery and neurological deficits. CT angiography successfully identified an underlying aortic dissection in a patient presenting with acute stroke symptoms, preventing the potentially fatal administration of intravenous tPA.
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