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Case Reports
. 2019 Dec 1:20:1788-1792.
doi: 10.12659/AJCR.917179.

Aortic Dissection: An Easily Missed Diagnosis when Pain Doesn't Hold the Stage

Maria Mirabela Manea  1   2 , Dorin Dragos  3   4 , Florian Antonescu  1   2 , Adrian George Sirbu  5   6 , Andreea Taisia Tiron  7   8 , Ana Maria Dobri  2 , Sorin Tuta  1   2
Affiliations
Case Reports

Aortic Dissection: An Easily Missed Diagnosis when Pain Doesn't Hold the Stage

Maria Mirabela Manea et al. Am J Case Rep. .

Abstract

BACKGROUND Type A aortic dissection (AD) is a rare disease, with a high mortality rate. Its most common symptom is thoracic pain, which is nevertheless absent in about 6% of cases. Neurologic complications are extremely rare and include ischemic stroke and ischemic neuropathy (which are the most common as presenting symptoms), spinal cord ischemia, and hypoxic encephalopathy. These rare neurological presentations can often be missed at initial clinical examination. CASE REPORT We report 2 cases of patients presenting with seemingly mild neurological symptoms. However, diagnostic tests revealed acute type A AD, and further steps were taken. CONCLUSIONS Although it is a rare cause of transient stroke or peripheral nerve ischemia, AD should be quickly recognized as a potential cause of new-onset neurological manifestations.

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Conflict of interest statement

Conflict of interest: None declared

Conflicts of interest

None.

Figures

Figure 1.
Figure 1.
(A) Case 1: computed tomography angiography of the aorta showing the true and false lumen at the origin and filling defect-clot (horizontal red arrow). (B) Case 1: a true and false lumen of ascending aorta with a parietal thrombus (vertical red arrow).
Figure 2.
Figure 2.
(A) Case 2: computed tomography angiography image shows aortic arch dissection (red arrow). (B) Case 2: thrombosis of the false lumen in the descending thoracic aorta (red arrow) and flap of dissection into ascending aorta (yellow arrow). (C) Case 2: dissection of right common carotid artery (green arrow) and right subclavian artery with filling defect-clot (blue arrow). (D) Case 2: dissection of the brachiocephalic trunk (yellow arrow).
See this image and copyright information in PMC

References

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