Abstract
We report the case of 62-year-old woman who arrived at our hospital within 40 min from onset, after she had suddenly become aware of paresis and paresthesia in her right leg. Although she denied any chest, back, or abdominal pain, she reported knotted neck pain only before the onset of her leg symptoms. Due to her clear consciousness and atypical pain, we suspected not only stroke but also acute aortic dissection. We immediately conducted helical contrast CT scanning from the neck to the pelvis following conventional CT scanning of the head. On the contrast CT scan, we diagnosed a type A acute aortic dissection and consequent occlusion of the right femoral artery. After the diagnosis, the right femoral pulse was confirmed unpalpable. Emergent replacement of the ascending aorta and aortic arch using a prosthetic graft was carried out. In addition, bypass grafting from the left to right femoral artery was successfully performed. Contrast CT scanning of the chest and abdomen following CT scanning of the head is regarded as most available for the detection of aortic dissection, especially in the case of considering rt-PA therapy for acute ischemic stroke.
