Subarachnoid haemorrhage in a patient with undiagnosed aortic coarctation
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A man in his mid-30s was admitted with a thunderclap headache. He was conscious and hypertensive. A decade earlier, severe hypertension had been diagnosed and extensively investigated without revealing an underlying cause. Brain imaging showed subarachnoid haemorrhage caused by a ruptured pericallosal aneurysm. Endovascular occlusion was attempted, but as the sheath could not pass the aortic arch, it was converted to surgical aneurismal clipping. Intraoperative blood pressure measurement revealed a peak-to-peak gradient of 100 mm Hg across the aortic arch and an ankle/brachial index of 0.46 (normal range 0.9-1.2). Aortic coarctation was suspected, and angiographic imaging and echocardiography confirmed the diagnosis. Subacute direct stenting was performed, which normalised the peak-to-peak gradient and ankle/brachial index. To minimise the risk of severe complications, early diagnosis of aortic coarctation is important and can be facilitated by ankle/brachial index and echocardiography in the suprasternal view.
Originalsprog | Engelsk |
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Artikelnummer | e247364 |
Tidsskrift | BMJ Case Reports |
Vol/bind | 15 |
Udgave nummer | 4 |
Antal sider | 4 |
ISSN | 1757-790X |
DOI | |
Status | Udgivet - 2022 |
Bibliografisk note
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