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Common complications include stroke, spinal cord ischemia, and transient ischemic attacks, with stroke being the most prevalent. Managing aortic dissection necessitates careful blood pressure control to prevent dissection progression while avoiding compromised cerebral and spinal perfusion. Carotid involvement, particularly dissection, increases stroke and transient ischemic attack risks. Emergency surgical interventions, though essential to prevent rupture or repair dissection, carry risks of perioperative neurovascular complications. The use of electroencephalography and transcranial Doppler can aid in the early detection and monitoring of neurovascular events. We discuss the pros and cons of certain blood pressure medications in the acute treatment of aortic dissection. A multidisciplinary approach involving cardiovascular surgeons, neurologists, and critical care specialists is vital for optimizing outcomes and mitigating risks. Early recognition and management of neurovascular complications are crucial, and further research is needed to develop targeted prevention and treatment strategies.<\/jats:p>","DOI":"10.5853\/jos.2024.02915","type":"journal-article","created":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T02:39:28Z","timestamp":1738291168000},"page":"19-29","update-policy":"https:\/\/doi.org\/10.5853\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Neurovascular Complications of Acute Aortic Syndrome"],"prefix":"10.5853","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-4049-7831","authenticated-orcid":true,"given":"Dean","family":"Zeldich","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Bierowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leah","family":"Shabo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sridhara","family":"Yaddanapudi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregary","family":"Marhefka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3882","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.105.534198"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.283.7.897"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1007\/s43678-022-00413-x"},{"key":"ref4","first-page":"1103","volume-title":"Thoracic aortic aneurysms: a population-based study","author":"Bickerstaff","year":"1982"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1378\/chest.117.5.1271"},{"key":"ref6","first-page":"350","volume-title":"Presentation, diagnosis, and outcomes of acute aortic dissection: 17-year trends from the international registry of acute aortic dissection","author":"Pape","year":"2015"},{"key":"ref7","first-page":"375","volume-title":"Advances in management of acute hypertension: a concise review","author":"Tulman","year":"2012"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-022-01661-6"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2018.01.056"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1097\/ccm.0b013e3182227238"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0404.1999.tb07352.x"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.105.001479"},{"key":"ref13","first-page":"e344","volume-title":"Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 guidelines for the early management of acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association\/American Stroke Association","author":"Powers","year":"2019"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-197601000-00004"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/49.5.419"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-197909000-00009"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1980.53.3.0309"},{"key":"ref18","first-page":"1106","volume-title":"Simple hypothermic retrograde cerebral perfusion during aortic arch replacement. 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