References:
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2. Morihara R, Yamashita T, Deguchi K, et al. Successful Delayed Aortic Surgery for a Patient with Ischemic Stroke Secondary to Aortic Dissection. Intern Med. 2017 Sep 1;56(17):2343-2346.
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Figure legends:
Figure 1. CT angiography of head and neck with contrast (A) and CT of the head without contrast (B).
A. Thrombosis in the right internal carotid artery (Red arrow) and intramural hematoma in the aortic arch (Yellow arrow). B. Initial concern of large vessel occlusion in the right middle cerebral artery (Red arrow).
Fig.2. CTA on day 0, day 5, and postoperative image.
A. An initial CTA demonstrated type A intramural hematoma (IMH) in the ascending aorta just above the aortic root and extending as far as the transverse arch proximal to the left subclavian artery. The size of the ascending aorta was 5.1 cm. The distal arch and proximal descending aorta were dilated to 5.4 cm.
B. A follow-up CTA on day 5 showed the ascending aorta was stable in size. The size of IMH decreased from 10mm to 5mm.
C. Total arch replacement with frozen elephant trunk and previous endovascular stent graft for abdominal aortic aneurysm.