Premium
Neurologic complications of type I aortic dissection
Author(s) -
Blanco M.,
DíezTejedor E.,
Larrea J. L.,
Ramírez U.
Publication year - 1999
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/j.1600-0404.1999.tb07352.x
Subject(s) - medicine , aortic dissection , aortic arch , ascending aorta , ischemia , stroke (engine) , dissection (medical) , encephalopathy , aorta , spinal cord , surgery , posterior reversible encephalopathy syndrome , cardiology , magnetic resonance imaging , radiology , mechanical engineering , psychiatry , engineering
Background – Aortic dissection (AoD) is characterized by a transverse intimal tear that in most cases occurs in the right lateral wall of the ascending aorta. Neurological deficit is seen as an initial manifestation in about 20% of patients (8%–33%). Objectives – To analyze the frequency of these complications and the underlying pathogenic mechanisms. Methods – Retrospective review of the neurologic complications of patients with type I AoD who underwent surgical treatment between January 1988/April 1996. Results – We report 24 patients. Nine (37.7%) developed neurologic symptoms which we have classified as follows: Hypoxic encephalopathy, 5 (55.5%); ischemic stroke, 2 (22.2%); ischemic neuropathy, 2 (22.2%) and spinal cord ischemia, 1 (11.1%). One is included in both first and third group. Conclusions – Neurologic complications are frequent in type I AoD, mainly focal or global cerebral ischemia. The former could be due to advancement of the false channel towards the aortic arch vessels and the latter to global central nervous system hypoperfusion.