Acute aortic dissection mimicking basilar artery occlusion in a patient presenting with sudden coma

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

A 77-year-old female suddenly became comatose. Examination at the emergency room revealed stable vital signs and bilateral positive plantar reflexes but absent brainstem reflexes. Basilar artery occlusion was initially diagnosed and recombinant tissue plasminogen activator was administered. However, her blood pressure dropped after thrombolysis. A chest CT scan showed aortic dissection extending to the bilateral common carotid arteries. Her follow-up brain CT scan disclosed infarctions over bilateral carotid territories without brainstem involvement. Aortic dissection should be listed as a possible diagnosis in a patient who presents with a sudden coma mimicking basilar artery occlusion. Detailed clinical examination and discussion might lead to the correct diagnosis and avoid inadvertent thrombolysis in the emergency room.

Original languageEnglish
Pages (from-to)952-953
Number of pages2
JournalJournal of Clinical Neuroscience
Volume17
Issue number7
DOIs
Publication statusPublished - 2010 Jul 1

Fingerprint

Basilar Artery
Coma
Brain Stem
Dissection
Hospital Emergency Service
Abnormal Reflexes
Vital Signs
Common Carotid Artery
Tissue Plasminogen Activator
Infarction
Reflex
Thorax
Blood Pressure
Brain

All Science Journal Classification (ASJC) codes

  • Surgery
  • Neurology
  • Clinical Neurology
  • Physiology (medical)

Cite this

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abstract = "A 77-year-old female suddenly became comatose. Examination at the emergency room revealed stable vital signs and bilateral positive plantar reflexes but absent brainstem reflexes. Basilar artery occlusion was initially diagnosed and recombinant tissue plasminogen activator was administered. However, her blood pressure dropped after thrombolysis. A chest CT scan showed aortic dissection extending to the bilateral common carotid arteries. Her follow-up brain CT scan disclosed infarctions over bilateral carotid territories without brainstem involvement. Aortic dissection should be listed as a possible diagnosis in a patient who presents with a sudden coma mimicking basilar artery occlusion. Detailed clinical examination and discussion might lead to the correct diagnosis and avoid inadvertent thrombolysis in the emergency room.",
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Acute aortic dissection mimicking basilar artery occlusion in a patient presenting with sudden coma. / Sung, Pi-Shan; Fang, Chen Wen; Chen, Chih-Hung.

In: Journal of Clinical Neuroscience, Vol. 17, No. 7, 01.07.2010, p. 952-953.

Research output: Contribution to journalArticle

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