Spontaneously Sealed Aortic Dissection Presenting with Multiple Ischemic Strokes

Introduction Aortic dissection is a rare and potentially fatal disease. It usually presents with severe chest pain radiating to the back, isolated back pain, or abdominal pain. 1 Atypical symptoms such as dizziness, vertigo, syncope, weakness or numbness are uncommon. The prevalence of neurologic symptoms in aortic dissection account for up to 42% of cases. 2 One study revealed that 29% of patients with type A aortic dissection presented with neurologic manifestations, but only two-thirds of these patients reported chest pain. 3 Based on these percentages, approximately 10% of patients present with neurologic symptoms and without chest pain. Neurologic manifestation in aortic dissection included ischemic stroke (16%), ischemic neuropathy (11%), syncope (6%), seizures (3%), hypoxic encephalopathy (2%), and spinal cord ischemia (1%). 3