Skip to main content
The Kaohsiung Journal of Medical Sciences logoLink to The Kaohsiung Journal of Medical Sciences
. 2009 Jul 14;23(1):45–49. doi: 10.1016/S1607-551X(09)70374-2

Painless Aortic Dissection with Initial Symptom of Right Upper Extremity Weakness: A Case Report

Kuan‐Ting Liu 1, Hon‐Man Chan 1,2, Tzeng‐Jih Lin 1,3,
PMCID: PMC11917992  PMID: 17282986

Abstract

Thoracic aortic dissection is a dangerous disease. It usually presents as severe chest or back pain. Symptoms resulting from aortic branch involvement may also be involved. Sometimes, it presents with atypical symptoms. Here, we report a patient who came to the emergency department (ED) because of acute onset of right upper limb weakness and numbness. Brain computed tomography (CT) was performed initially because cerebral vascular disease was suspected. Subsequently, angiography was performed as artery occlusion of the limb was found. The patient suddenly collapsed in the ED. Stanford type A acute aortic dissection was found by chest CT.

Keywords: aortic dissection, painless, paralysis, thoracic aorta

Full Text

The Full Text of this article is available as a PDF (681.5 KB).

References

  • 1. Hagan PG, Nienaber CA, Isselbacher EM, et al. The International Registry of Acute Aortic Dissection (IRAD): new insights into an old disease. JAMA. 2000; 283: 897–903. [DOI] [PubMed] [Google Scholar]
  • 2. Khan IA, Nair CK. Clinical, diagnostic, and management perspectives of aortic dissection. Chest. 2002; 122: 311–328. [DOI] [PubMed] [Google Scholar]
  • 3. Prendes JL. Neurovascular syndromes in aortic dissection. Am Fam Physician. 1981; 23: 175–179. [PubMed] [Google Scholar]
  • 4. Koushima R, Kikuchi Y, Sakurada T, et al. A case of painless Stanford type A acute aortic dissection complicating acute occlusion of the right subclavian artery. Kyobu Geka. 1998; 51: 226–230. [PubMed] [Google Scholar]
  • 5. Holloway SF, Fayad PB, Kalb RG, et al. Painless aortic dissection presenting as a myelopathy. J Neurol Sci. 1993; 120: 141–144. [DOI] [PubMed] [Google Scholar]
  • 6. Beach C, Manthey D. Painless acute aortic dissection presenting as left lower extremity numbness. Am J Emerg Med. 1998; 16: 49–51. [DOI] [PubMed] [Google Scholar]
  • 7. Inamasu J, Hori S, Yokoyama M, et al. Paraplegia caused by painless acute aortic dissection. Spinal Cord. 2000; 38: 702–704. [DOI] [PubMed] [Google Scholar]
  • 8. Joo JB, Cummings AJ. Acute thoracoabdominal aortic dissection presenting as painless, transient paralysis of the lower extremities: a case report. J Emerg Med. 2000; 19: 333–337. [DOI] [PubMed] [Google Scholar]
  • 9. Donovan EM, Seidel GK, Cohen A. Painless aortic dissection presenting as high paraplegia: a case report. Arch Phys Med Rehabil. 2000; 81: 1436–1438. [DOI] [PubMed] [Google Scholar]
  • 10. Rosen SA. Painless aortic dissection presenting as spinal cord ischemia. Ann Emerg Med. 1988; 17: 840–842. [DOI] [PubMed] [Google Scholar]
  • 11. Greenwood WR, Robinson MD. Painless dissection of the thoracic aorta. Am J Emerg Med. 1986; 4: 330–333. [DOI] [PubMed] [Google Scholar]
  • 12. Morita S, Shibata M, Nakagawa Y, et al. Painless acute aortic dissection with a left hemiparesis. Neurocrit Care. 2006; 4: 234–236. [DOI] [PubMed] [Google Scholar]
  • 13. Veyssier‐Belot C, Cohen A, Rougemont D, et al. Cerebral infarction due to painless thoracic aortic and common carotid artery dissections. Stroke. 1993; 24: 2111–2113. [DOI] [PubMed] [Google Scholar]
  • 14. Petasnick JP. Radiologic evaluation of aortic dissection. Radiology. 1991; 180: 297–305. [DOI] [PubMed] [Google Scholar]
  • 15. Guthaner D, Miller DG. Digital subtraction angiography of aortic dissection. AJR Am J Roentgenol. 1983; 141: 157–161. [DOI] [PubMed] [Google Scholar]
  • 16. Dinsmore RE, Willerson JJ, Buckley MJ. Dissecting aneurysms of the aorta: aortographic features affection prognosis. Radiology. 1972; 105: 567–572. [DOI] [PubMed] [Google Scholar]
  • 17. Eagle K, Quertemous T, Kritzer G, et al. Spectrum of conditions initially suggesting acute aortic dissection but with negative aortogram. Am J Cardiol. 1986; 57: 322–326. [DOI] [PubMed] [Google Scholar]
  • 18. Cigarroa JE, Isselbacher EM, DeSanctis RW, et al. Diagnostic imaging in the evaluation of suspected aortic dissection: old standards and new directions. N Engl J Med. 1993; 328: 35–43. [DOI] [PubMed] [Google Scholar]

Articles from The Kaohsiung Journal of Medical Sciences are provided here courtesy of Kaohsiung Medical University and John Wiley & Sons Australia, Ltd

RESOURCES