# The Other Aortic Syndrome–Intramural Hematoma and Neurological Deficit: Case Report

## TL;DR

A 67-year-old woman with a rare aortic condition and sudden paralysis highlights the importance of quick diagnosis and blood pressure management to prevent spinal damage.

## Contribution

This case report presents a rare instance of intramural hematoma with neurological deficit and suggests spinal drains as a potential treatment.

## Key findings

- Intramural hematoma can present with neurological deficits such as paraparesis.
- Spinal drain placement and blood pressure control may optimize spinal cord perfusion in such cases.

## Abstract

Acute thoracic aortic syndromes are among the most concerning presentations in emergency medicine and are associated with significant morbidity and mortality. Thoracic aortic dissection is most common, followed by penetrating aortic ulcer and, least commonly, intramural hematoma.

A 67-year-old woman presented to the emergency department with chest and back pain, and sudden onset of paraparesis. Aortic intramural hematoma was diagnosed, and she underwent spinal drain placement with blood pressure control to optimize spinal cord perfusion.

When neurological deficits are present, rapid diagnosis of spinal ischemia and blood pressure optimization is vital. Spinal drains may be considered as an adjunctive treatment.