title: [Type A acute aortic dissection presenting as mental status confusion: is it an atypically really uncommon presentation?].
abstract: The most common initial symptom of acute aortic dissection is chest or abdominal pain. Nevertheless, in a minority of cases, it may have an atypical presentation, making the diagnosis clinically challenging. This article reports on a case of acute type A aortic dissection presenting as mental status confusion. The diagnostic suspicion for a cerebrovascular accident may have catastrophic consequences in a clinical condition, which is associated with a high mortality during the first 48 hours after the onset of symptoms if untreated. The right diagnosis was made by combining a careful physical examination, echocardiography, and computed tomography. The available literature about neurologic manifestations, their pathophysiology and prevalence as the initial symptom of acute type A aortic dissection is reviewed.
authors.affiliation: Divisione di Cardiologia, Ospedale S. Maria del Carmine, Rovereto (TN). imperadoref@seldati.net
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Imperadore
authors.forename: Giovanni
authors.initials: G
authors.lastname: Morani
authors.forename: Fausto
authors.initials: F
authors.lastname: Tilotta
authors.forename: Gerardo
authors.initials: G
authors.lastname: Musuraca
authors.forename: Claudio
authors.initials: C
authors.lastname: Cemin
authors.forename: Piergiuseppe
authors.initials: P
authors.lastname: De Girolamo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Vergara
mesh_terms: D000784:Aortic Dissection / Q000175:diagnosis / Q000523:psychology* / Q000601:surgery; D001011:Aorta / Q000000981:diagnostic imaging; D001014:Aortic Aneurysm / Q000175:diagnosis / Q000523:psychology* / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000523:psychology* / Q000601:surgery; D001022:Aortic Valve Insufficiency / Q000150:complications / Q000601:surgery; D001027:Aortography; D019917:Blood Vessel Prosthesis Implantation; D016122:Brachiocephalic Trunk; D002545:Brain Ischemia / Q000175:diagnosis; D003221:Confusion / Q000209:etiology*; D003937:Diagnosis, Differential; D004452:Echocardiography; D006261:Headache / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D014839:Vomiting / Q000209:etiology