Acute aortic dissection (AAD) masquerading as ischaemic stroke can be a challenging diagnosis for clinicians and can pose complications for the patient. Type A dissections extending into the vessels of the brain and neck can cause cerebral hypoperfusion leading to strokes or stroke-like symptoms. Thrombolysis of ischaemic strokes caused due to aortic dissection can be catastrophic for the patient. We present a series of two cases of aortic dissection presenting as strokes which were thrombolysed and underwent surgical intervention for dissection but did not suffer catastrophic complications. We do not recommend to rule out dissection in acute stroke patients before thrombolysis.
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