title: Painless acute aortic dissection with a left hemiparesis.
abstract: 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.
authors.affiliation: 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
authors.forename: Seiji
authors.initials: S
authors.lastname: Morita
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Shibata
authors.forename: Yoshihide
authors.initials: Y
authors.lastname: Nakagawa
authors.forename: Isotoshi
authors.initials: I
authors.lastname: Yamamoto
authors.forename: Sadaki
authors.initials: S
authors.lastname: Inokuchi
mesh_terms: 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*