Paraplegia and acute aortic dissection: a diagnostic challenge for physicians in the emergency situation

Abstract

Acute aortic dissection presenting neurological symptoms is rare and entails significant diagnostic challenges. We present a case of 45-year-old woman with a medical history of essential hypertension and smoking, admitted with lobar pneumonia. During her inpatient treatment, she developed severe back pain and numbness below the level of the umbilicus. Due to her presenting symptoms considered differential diagnoses were paravertebral abscess and acute stroke. CT scan of the head did not reveal any ischaemic changes. Further investigation with MRI (with and without contrast) raised concerns for possible aortic dissection. CT angiography of thorax, abdomen and pelvis displayed extensive aortic dissection extending from aortic root to left iliac artery limiting flow to right carotid artery causing stenosis. The patient was diagnosed with Stanford type A aortic dissection. The patient was referred to the cardiothoracic surgery team for surgical repair. The patient made a good recovery after a prolonged course of hospitalisation, followed by cardiac rehabilitation and physical therapy.

Unruptured aneurysm with intramural thrombus is an unusual cause of spinal cord infarction: a case report

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S100A1 as a potential biomarker for the diagnosis of patients with acute aortic dissection

“… 16 The primary methods for diagnosing AAD are magnetic resonance imaging, computed tomography angiography, and ultrasound, which are regarded as diagnostic challenges for physicians in emergency cases. 17 Thus, a set of markers with high sensitivity and specificity are needed for the early diagnosis of AAD in the clinic.…”

S100 proteins in cardiovascular diseases

“…Acute aortic dissection is often misdiagnosed as acute myocardial infarction or other cardiovascular disease due to the lack of typical symptoms, leading to delays in treatment. Meanwhile, the diagnosis of acute aortic dissection mainly depends on various imaging technologies, such as magnetic resonance imaging, computed tomography angiography, and ultrasound (Memon et al 2019 ). Imaging technologies are relatively time-consuming or unavailable in some hospitals (Carroll et al 2020 ; Liu and Huang 2018 ; Carpenter et al 2014 ).…”