意识障碍首诊诊断主动脉夹层并出血性脑卒中1例

First diagnosis of aortic dissection and hemorrhagic stroke with disturbance of consciousness

主动脉夹层(aortic dissection,AD)是迅速危及生命的急危重病,剧烈的胸痛症状是患者就诊的主要原因,这类患者往往会引起首诊医师的重视,其漏诊、误诊相对较低。但有6%~17%的AD患者无典型胸痛症状,这类患者极易被忽视,漏诊、误诊率高。尤其是并发脑卒中时,因神经系统症状的异质性,更易漏诊,延误患者治疗。现报1例以意识障碍为首发症状诊断主动脉夹层并出血性脑卒中病例,以期提高临床医师对该病的认识。

Aortic dissection(aortic dissection, AD) is a rapidly life-threatening acute and critical disease. Severe chest pain symptoms are the main cause of the patient’s visit. This kind of attract the attention of the first physician, and their missed diagnosis and misdiagnosis are relatively low. But there are 6%-17% of AD patients without typical chest pain symptoms, such patients are easily ignored, missed diagnosis, high misdiagnosis rate. Especially in concurrent stroke, because of the heterogeneity of nervous system symptoms, it is easier to miss diagnosis and delay the treatment of patients. We present a case of aortic dissection and hemorrhagic stroke with disturbance of consciousness as the first symptom in order to improve clinical practice doctor’s understanding of the disease.