A RARE CAUSE OF STROKE - AORTIC DISSECTIO N

Dissections of the internal carotid and vertebral arteries are well-kn own causes of cerebral infarctions. These diagnoses are regularly cons idered in differentiating aetiology of stroke. Dissections of aortic a rch and common carotid artery, however, may be overlooked as causes of ischaemic stroke. We report on a 62-year old man who was admitted bec ause of thoracic pain. The next day the patient developed a hemiplegia . After exclusion of myocardial infarction we performed a cervical ult rasound examination. Colour flow duplex scanning showed a dissection o f both common carotid arteries extending to the bifurcation. These fin dings were considered to be part of aortic arch dissection, as separat e common carotid artery dissection is extremely rare. Transoesophageal echocardiography actually showed a dissecting aneurysm of the aorta ( Typ I according to DeBakey), while transthoracal echocardiography was normal. Aortic dissection may present as an uncharacteristic syndrome and therefore a correct diagnosis may fail at initial presentation. Ao rtic dissection may result in acute neurologic symptoms only and in th is case may be detected by neurologists.