Published online Aug 26, 2022. doi: 10.12998/wjcc.v10.i24.8673
Peer-review started: February 12, 2022
First decision: May 30, 2022
Revised: June 13, 2022
Accepted: July 22, 2022
Article in press: July 22, 2022
Published online: August 26, 2022
Processing time: 184 Days and 16.2 Hours
DeBakey type I aortic dissection is one of the rare etiologies of ischemic stroke. It is critical to identify arterial dissection before intravenous thrombolysis; otherwise, fatal hemorrhage may occur.
In this report, we described 2 painless DeBakey type I aortic dissection cases with initial symptoms similar to ischemic stroke. Sudden onset of conscious disturbance and limb weakness within minutes occurred in both cases. Hypotension was found in both cases. Thoracoabdominal computed tomography angiography was urgently performed due to unknown reason hypotension, and DeBakey type I aortic dissection was confirmed. Intravenous thrombolysis was avoided because of timely diagnosis; however, they both eventually died of ruptured aortic dissection.
Aortic dissection should always be excluded in ischemic stroke patients with unexplained hypotension or shock symptoms before intravenous thrombolytic therapy.
Core Tip: Aortic dissection should always be excluded in ischemic patients with unexplained hypotension or shock symptoms before intravenous thrombolytic therapy. These two painless DeBakey Type I aortic dissection cases with initial symptoms similar to ischemic stroke intravenous thrombolysis was avoided because of timely diagnosis.