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Medical Science Monitor Basic Research


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

Challenging differential diagnosis

Maria Mirabela Manea, Dorin Dragos, Florian Antonescu, Adrian George Sirbu, Andreea Taisia Tiron, Ana Maria Dobri, Sorin Tuta

Romania Department of Neurology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania

Am J Case Rep 2019; 20:1788-1792

DOI: 10.12659/AJCR.917179

Available online: 2019-12-01

Published: 2019-12-01


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.

Keywords: Aortic Diseases, Ischemic Attack, Transient, Paresis