![]() ![]() The authors also attest that this clinical investigation was determined to require the Institutional Review Board/Ethics Committee review, and the corresponding protocol/approval number is (298). The authors of this manuscript declare that this scientific work complies with reporting quality, formatting, and reproducibility guidelines set forth by the EQUATOR Network. , Accordingly, physicians should evaluate aorta when treating patients with left hemiparesis, even chest or back pain is not involved. The most representative atypical sign of aortic dissection was left hemiparesis based on a decrease in the blood supply of the right carotid artery, which first branches off from the aortic arch. The risk factors for painless acute myocardial infarction were aging, female sex, and diabetes mellitus, which are thought to increase the threshold of pain, while aging and syncope are thought to be risk factors for painless aortic dissection, which occurred in our case. The cause of the hemiparesis in the present case was the complete occlusion of the internal carotid artery, and the transience might have been due to supplementary blood supply from the other left internal carotid and basilar arteries through Willis arterial circle. It was initially considered to represent a transient ischemic attack however, the final diagnosis was Stanford type A aortic dissection. CT of the head showed no abnormalities, and the patient's neurological symptoms disappeared suddenly. The first case involved a 59-year-old man with left-sided weakness of sudden onset. This is the second case of transient left hemiparesis due to aortic dissection in the English literature. Computed tomography reveals Stanford type A aortic dissection (arrow) Magnetic resonance angiography did not detect the right internal carotid artery, suggesting its occlusionįigure 3: Enhanced thoracic computed tomography on arrival. ![]() Head magnetic resonance diffusion-weighted imaging showed no fresh ischemic lesionsįigure 2: Magnetic resonance angiography on arrival. Her postoperative course was uneventful and she was discharged on foot without any neurological complications.įigure 1: Diffusion-weighted imaging on arrival. An emergency operation was performed to replace the ascending aorta. CT demonstrated Stanford type A aortic dissection. CT angiography was performed to evaluate the aorta and internal carotid arteries. Her fibrinogen degradation product level was 13.8 μg/mL. Head magnetic resonance diffusion-weighted imaging showed no fresh ischemic lesions however, the right internal carotid artery was not detected on magnetic resonance angiography, suggesting its occlusion and. Head computed tomography (CT) depicted old lacunar infarctions. Both physiological and neurological studies were negative. Percutaneous saturation was 98% under room air. Her heart rate was 76 beats/min, and regular. ![]() On arrival, she was managed by a neurosurgeon. She had a medical history of hypertension and cerebral infarction without sequelae, which was treated by an antiplatelet drug. She was transported to our hospital by ambulance and arrived approximately 2 h after the event. When emergency medical technicians checked her, she had hemiparesis with right conjugated deviation. She soon obtained consciousness spontaneously. The people who had accompanied her called an ambulance. We report an extremely rare case of transient left hemiparesis due to aortic dissection.Ī 75-year-old woman suddenly lost consciousness while singing in a karaoke box. In rare cases, transient left hemiparesis occurs after convulsion or is induced by subarachnoid hemorrhage. Available from: Ĭerebral ischemia is a common cause of transient hemiparesis. Transient left hemiparesis due to aortic dissection. #MURAMATSU SERIAL NUMBER LIST HOW TO#How to cite this URL: Muramatsu KI, Nagasawa H, Takeuchi I, Yanagawa Y. How to cite this article: Muramatsu KI, Nagasawa H, Takeuchi I, Yanagawa Y. Ken-Ichi Muramatsu, Hiroki Nagasawa, Ikuto Takeuchi, Youichi Yanagawaĭepartment of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Izunokuni, Shizuoka, JapanĬlick here for correspondence address and email Date of Submission Transient left hemiparesis due to aortic dissection ![]()
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