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  • Title: Combined cardiac-neurosurgical treatment of acute aortic dissection, stroke, and coma.
    Author: Iliescu VA, Dorobantu LF, Stiru O, Bubenek S, Miclea I, Rugina M, Boros C, Georgescu S.
    Journal: Tex Heart Inst J; 2008; 35(2):200-2. PubMed ID: 18612454.
    Abstract:
    Coma or stroke with secondary brain malperfusion is usually considered a strong contraindication for emergent surgical treatment of acute aortic dissection. Herein, we present the case of a 30-year-old woman who presented with sudden left hemiplegia and level-7 coma on the Glasgow Coma Scale. Transthoracic echocardiography showed type A aortic dissection. Although the patient was unable to communicate, her family approved an emergency Bentall operation. She regained consciousness but developed anisocoria and Glasgow Coma Scale level-4 coma 30 hours after the operation. Computed tomography showed massive cerebral infarction with hernia of the uncus gyri hippocampi. Emergency surgical cerebral decompression was performed. The patient survived; after 1 year, she had full mental acuity and minor left motor sequelae.
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