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

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 com...

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Bibliographic Details
Published in:The American journal of case reports 2019-12, Vol.20, p.1788-1792
Main Authors: Manea, Maria Mirabela, Dragos, Dorin, Antonescu, Florian, Sirbu, Adrian George, Tiron, Andreea Taisia, Dobri, Ana Maria, Tuta, Sorin
Format: Article
Language:English
Subjects:
Aged
Aneurysm, Dissecting - complications
Aneurysm, Dissecting - diagnostic imaging
Aneurysm, Dissecting - surgery
Computed Tomography Angiography
Fatal Outcome
Female
Humans
Ischemic Attack, Transient - etiology
Male
Missed Diagnosis
Paresis
Peripheral Nervous System Diseases - etiology
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Summary: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.
ISSN:1941-5923
1941-5923
DOI:10.12659/AJCR.917179