A cryptic ascending aortic thrombus early diagnosed with CT angiography: A case of embolic strokes of undetermined source

Abstract

However ascending aortic thrombus is rare, has a potential of embolic strokes of undetermined source (ESUS). Prompt diagnosis and definitive treatment are imperative to decrease morbidity and mortality. We report a case of ascending aortic thrombus early diagnosed with computed tomography angiography (CTA). A 61-year-old man on post-operative chemotherapy for rectal cancer presented with sudden headache and vertigo. Magnetic resonance imaging depicted right cerebellar infarction, and CTA depicted a 20-mm mass at the ascending aorta. Emergency ascending aorta replacement was performed. Histological analysis demonstrated a fresh, mixed thrombus and early atherosclerotic changes at the aortic wall. CTA is useful in the early diagnosis of ascending aortic thrombus. Imaging of the aortic arch through CTA should be considered in ESUS patients.