Thrombolysis in a stroke patient with Marfan syndrome

Marfan syndrome is an autosomal dominant inherited disorder of the connective tissue with pleiotropic manifestations in the classic triad of ocular, skeletal, and cardiovascular systems. Characteristic clinical features include a thin tall stature, pectus carinatum or excavatum, scoliosis, joint hypermobility, arachnodactyly, pes planus, a high arched palate, and ectopia lentis.1 The syndrome has an incidence of around 1 in 9800.2 Weakness of the blood vessels, especially the aorta, causes progressive dilatation of the aortic root leading to aortic regurgitation, dissection, or rupture, which is the most common life threatening feature of the Marfan syndrome.1 Neurovascular complications of Marfan syndrome are rare, and mostly ischaemic in nature.3 An association between Marfan syndrome and intracranial aneurysms has been described in one autopsy series of 7 cases in 1997,1 but was not confirmed in larger autopsy series of 25 Marfan cases.1 Thrombolysis is now a standard treatment for acute ischaemic stroke. We found no report of thrombolytic treatment for acute ischaemic stroke in patients with Marfan syndrome in the literature.