Unexpected Outcomes of Intravenous Thrombolysis in a Patient with Aortic Dissection Undergoing Delayed Surgical Intervention Presenting as Acute Ischemic Stroke: A Case Study - Takeaways - MDSpire

Unexpected Outcomes of Intravenous Thrombolysis in a Patient with Aortic Dissection Undergoing Delayed Surgical Intervention Presenting as Acute Ischemic Stroke: A Case Study

  • By

  • Tomokazu Kosuga

  • Yukio Hosokawa

  • Hidetsugu Hori

  • Keiichiro Tayama

  • October 31, 2025

  • 0 min

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  • 1

    Acute aortic dissection (AAD) can present as acute ischemic stroke (AIS), leading to inappropriate intravenous thrombolysis (IVT) despite its contraindications.

  • 2

    An 87-year-old woman received IVT for AIS caused by AAD, resulting in unchanged paralysis and subsequent expansion of cerebral infarction.

  • 3

    Emergency aortic surgery was delayed due to risks of surgical bleeding and thrombolysis-related intracerebral hemorrhage, despite indications for surgery.

  • 4

    New cerebral infarctions were detected 24 hours after IVT, attributed to embolic events rather than direct complications from AAD.

  • 5

    The patient underwent successful aortic surgery after fibrinogen levels recovered, leading to a favorable outcome without new neurological deficits.

Original Source(s)

Unexpected Outcomes of Intravenous Thrombolysis in a Patient with Aortic Dissection Undergoing Delayed Surgical Intervention Presenting as Acute Ischemic Stroke: A Case Study

  • by Tomokazu Kosuga, Yukio Hosokawa, Hidetsugu Hori, Keiichiro Tayama

  • October 31, 2025

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