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Seizure as initial manifestation of aortic dissection type a.
MedLine Citation:
PMID:  21293775     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Seizure as the initial manifestation of aortic dissection is rare.
CASE REPORT: An 88-year-old female experienced a first generalized tonic clonic seizure, which was terminated with midazolam. Acute cerebral magnetic resonance imaging and angiography were non-informative. After awaking she complained about cramping pain in the right upper extremity, which was accompanied by involuntary flexion movements of the right upper extremity. Blood pressure was initially normal. Blood gases revealed metabolic acidosis and blood chemical investigations a markedly increased D-dimer. Consecutively blood pressure declined and transthoracic echocardiography showed pericardial effusion. A computed tomography scan of the thorax revealed an aortic dissection type A. The patient died 16 hours after admission after cardiothoracic surgeons had refused surgical treatment.
CONCLUSION: This case shows that a generalized tonic-clonic seizure may be the initial manifestation of an aortic dissection type A in the absence of thoracic chest pain and that brachyalgia may not develop earlier than with progression of the dissection.
Authors:
Josef Finsterer; Marlies Frank; Hans Keller; Adam Bastowanski
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The western journal of emergency medicine     Volume:  11     ISSN:  1936-9018     ISO Abbreviation:  West J Emerg Med     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2011-02-04     Completed Date:  2011-07-14     Revised Date:  2011-07-25    
Medline Journal Info:
Nlm Unique ID:  101476450     Medline TA:  West J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  510-1     Citation Subset:  -    
Affiliation:
Vienna, Austria, Europe.
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