Research Article
Conservative Treatment of Acute Intracerebral Hemorrhage Occurred with Complicated Type B Aortic Dissection：Case Report and Literature Review
Jie liu1,*, Dao-Kai Gong2,*,✉
1Department of Neurology, the Second Clinical Medical College, Yangtze University, Jingzhou 434020, Hubei, China. 2Department of Neurology, Jingzhou Central Hospital of Yangtze University, 60 Jingzhong Road, Jingzhou 434020, Hubei, China.
*,These authors contributed equally. ✉,Correspondence Dao-Kai Gong, Department of Neurology, Jingzhou Central Hospital of Yangtze University, 60 Jingzhong Road, Jingzhou 434020, Hubei, China. E-mail: [email protected]. Telephone number: 18972160708. Received: December 28, 2019; Accepted: April 6, 2020; Published online: May 26, 2020. Cite this paper: Liu, J., and Gong, D.K. (2020) Conservative Treatment of Acute Intracerebral Hemorrhage Occurred with Complicated Type B Aortic Dissection：Case Report and Literature Review. Global Journal of Neuroscience, 1(1):10-16. https://naturescholars.com/gjn.010103. https://doi.org/10.46633/gjn.010103. Copyright© 2020 by Scholars Publishing, LLC.
Abstract
The concurrence of acute intracerebral hemorrhage and complicated acute aortic dissection is destructive and extremely rare. Surgical treatment poses a high risk to patients with this type comorbidity; however, a medical treatment could be an alternative in acute phase. We described a case of a 63-year-old male with hypertension who emergently presented at our institution with left-sided limb weakness. A head computed tomography (CT) scan showed 30mL of superficial intracerebral hemorrhage located in the right frontal-parietal lobe. On the third day, painless aortic dissection was found by accident in a routine chest CT examination. CT angiography confirmed the acute type B aortic dissection complicated with malperfusion syndrome of left renal. By conservative means, we controlled the systolic blood pressure varying from 100 to 120 mmHg persistently and smoothly for about a month. Until intracranial hematomas were mostly absorbed, a delayed thoracic endovascular aortic repair was performed to restore renal perfusion. Aggressive blood pressure lowering therapy would be important for improving long-term outcome.
To our knowledge, this is the first report of the conservative treatment of acute intracerebral hemorrhage occurred simultaneously with complicated type B acute aortic dissection.
Key words: Intracerebral hemorrhage; Aortic dissection; Blood pressure control; Delayed endovascular intervention.