Painless acute aortic dissection with a left hemiparesis.
BACKGROUND
Patients who present with only neurological symptoms and no pain challenge the recognition of acute aortic dissection.


RESULTS
We report three patients with completely painless acute aortic dissection who presented with left hemiparesis. All patients presented with a left-sided weakness of sudden onset. We suspected an ischemic stroke but diagnosed acute aortic dissection (DeBakey Type II, Stanford Type A). We suspect that the innominate artery is occluded when the blood flow of the false lumen is dominant. In our cases, surgical and autopsy findings showed dissection of the innominate artery.


CONCLUSIONS
Highly unusual presentations of aortic dissection with acute ischemic stroke exist. A wide mediastinum on plain chest X-ray was present in all cases.
Morita
Seiji
S
Tokai University School of Medicine, Department of Emergency and Critical Care Medicine, Bouseidai Isehara-City Kanagawa 259-1142, Japan. morito@is.icc.u-tokai.ac.jp
Shibata
Masayoshi
M
Nakagawa
Yoshihide
Y
Yamamoto
Isotoshi
I
Inokuchi
Sadaki
S
D000369:Aged, 80 and over; D001019:Aortic Rupture / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D002637:Chest Pain / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000209:etiology*