[Type A acute aortic dissection presenting as mental status confusion: is it an atypically really uncommon presentation?].
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.
Imperadore
Ferdinando
F
Divisione di Cardiologia, Ospedale S. Maria del Carmine, Rovereto (TN). imperadoref@seldati.net
Morani
Giovanni
G
Tilotta
Fausto
F
Musuraca
Gerardo
G
Cemin
Claudio
C
De Girolamo
Piergiuseppe
P
Vergara
Giuseppe
G
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