A case report of aortic arch dissection involving internal carotid artery in the form of massive cerebral infarction
Si Zengshun
Li Chengjun
Diao Jianwei
Abstract：A 65-year-old male presented with sudden onset of unconsciousness for one hour.His medical history included 30 years of hypertension,10 years of arrhythmia(treated with metoprolol),and severe stenosis of the right internal carotid artery at the ophthalmic segment with prior ischemic stroke.On admission,the patient was unconscious with right gaze deviation and left sided hemiplegia.Imaging examination revealed a large right hemispheric infarction and the occlusion of right internal carotid artery,initially suggesting thrombotic occlusion.Intravenous thrombolysis and endovascular intervention were performed,but intraoperative findings showed significantly reduced blood pressure on the right side compared to the left.Post procedural CT confirmed type A aortic dissection involving the right common carotid artery.Due to the extensive dissection and high surgical risk,the family opted for conservative treatment.The patient succumbed to cardiac tamponade and pump failure caused by aortic dissection extension to the aortic valve,9 hours post-onset.This case highlights the need for vigilance regarding aortic dissection in acute stroke patients,emphasizes the importance of comprehensive assessment and management,and underscores the critical impact of inadequate longterm blood pressure control on aortic diseases.
Keywords：Massive cerebral infarctionAortic dissectionIntravenous thrombolysisEndovascular treatment
Publication Date：2025-08-20
Online Publishing Date：2026-01-30(First online date of this platform, not the publication date of the document)
Pages：5( 76-80 )