Ischemic Infarction Disclose Aortic Dissection-A Case Report

因缺血性腦中風而發現主動脈剝離：病例報告

姜周禮(Chou-Li Chiang) ； 施瑞明(Joseph J. Shih)

《重症醫學雜誌》 12卷1期 (2011/03) Pp. 24-28

https://doi.org/10.30035/TCCM.201103.0004

摘要

高血壓未治療在臨床上常見且是出血性腦中風及主動脈剝離之危險因子。主動脈剝離有時會以中風來表現，對臨床診斷是一大考驗。我們報告一例因出血性腦中風住院，又繼發缺血性腦中風及主動脈剝離。我們藉由對患者施以顱骨切除，置入腦室引流管，滲透性利尿劑，止痛及鎮靜等方法來控制顱內壓。血壓之控制目標則是在能夠維持腦及重要器官之血液灌流。雖然這類病例很少但我們仍不要忘記其發生之可能。

關鍵字

主動脈剝離 ； 中風 ； 高血壓

並列摘要

Untreated hypertension is highly prevalent and an important risk factor for hemorrhagic stroke and aortic dissection. Aortic dissection masquerading as ischemic stroke is practically challenging. We report a patient who initially presented as having a hemorrhagic stroke, following with ischemic stroke several days later and was finally discovered to have aortic dissection. The patient underwent craniectomy, ventriculostomy catheter installation, osmotic diuretics, analgesia, and sedation to maintain ICP within the acceptable range. Our therapeutic goal of blood pressure is the lowest level commensurate with adequate cerebral and vital organ perfusion. Although very rare, we should always remind ourselves that aortic dissection may occur after a hypertensive hemorrhagic stroke, and then present simutaneously with ischemic stroke as in our case.

並列關鍵字

Aortic dissection ； Stroke ； Hypertension