Thoracic Aortic Dissecting Aneurysm Presenting with Stroke, Disseminated Intravascular Coagulopathy (DIC), and Gastrointestinal Hemorrhage

Main Article Content

Soraya Moghadam MD,
Yoshitsugu Nakamura MD,
Mackenzie Quantz MD,
Raymond Kao MD



Acute ischemic stroke secondary to vessel occlusion from an aneurismal dissection is an uncommon presentation. Disseminated intravascular coagulation (DIC) can present as a consequence of aortic dissection, although this is also rare. In some cases, the laboratory diagnosis of DIC uncovers a vascular abnormality or bleeding diathesis. This article describes a patient presenting with three sequential complications of a dissecting thoracic aortic aneurysm: ischemic stroke, upper gastrointestinal bleeding, and consumptive coagulopathy.
Abstract 261 | PDF Downloads 319 HTML Downloads 289


1. Sadhwani D, O’Mara K. Acute dissecting thoracic aneurysm presenting with stroke, consumptive coagulopathy, and gastrointestinal hemorrhage. Emerg Med J 2001;17:631—5.

2. Fann JL, Sarris GE, Miller DC, et al. Surgical management of acute aortic dissection complicated by stroke. Circulation 1989;80(Suppl 3):1257–63.

3. Cambria RP, Brewster DC, Gertler J, et al. Vascular complications associated with spontaneous aortic dissection. J Vasc Surg 1988;7:199–209.

4. Fisher DJ, Yawn DH, Crawford ES. Preoperative disseminated intravascular coagulation associated with aortic aneurysms. A prospective study of 76 cases. Arch Surg 1983;118:1252–5.

5. Eagle KA, DeSanctis RW. Aortic dissection. In: O’Rourke R, McCall D, eds. Current problems in cardiology, Vol.14. Chicago: Year Book Medical Publishers, 1989:225–78.

6. Hirst AE, Johns VJ, Kime SW. Dissecting aneurysm of the aorta: a review of 505 cases. Medicine 1958;37:217–79.

7. Fernandez-Moure JS, Vykoukai D, Davies MG. Biology of aortic aneurysm and dissections. Methodist Debakey Cardiovasc J 2001;7:2–7.

8. Fine NL, Applebaum J, lguezabal A, et al. Multiple coagulation defects in association with dissecting aneurysm. Arch Intern Med 1967;119:522–6.

9. Urakami K, Adachi Y, Takahashi K, et al. Cerebral infarction due to disseminated intravascular coagulation with thromboexculsion for dissecting aortic aneurysm. Jpn J Psychiatry Neurol 1989;43:241–4.

10. Libman R, Wirkowski E, Alvir J, et al. Conditions that mimic stroke in the emergency department. Arch Neuro 1995;52:1119–22.