# Extensive Type A Aortic Arterial Dissection Presenting With Stroke Symptoms: A Case Report

## TL;DR

A 60-year-old man with stroke-like symptoms was diagnosed with a severe aortic dissection and required urgent surgical care.

## Contribution

This case report highlights an unusual presentation of aortic dissection mimicking stroke and emphasizes the importance of rapid diagnosis and management.

## Key findings

- The patient presented with stroke-like symptoms but was diagnosed with extensive thoracic aortic dissection.
- CT angiography revealed dissection extending into multiple arteries and significant stenosis of the left common iliac artery.
- The patient was successfully transferred for urgent surgical intervention after initial stabilization.

## Abstract

Aortic dissection (AD) is a rare but often lethal condition if not properly and urgently treated. Most often, patients arrive with acute hemodynamic instability and ripping chest agony. The patient’s life depends critically on a correct diagnosis made as soon as possible. We describe a 60-year-old man who arrived at the emergency room with symptoms of a brain stroke, including poor consciousness, left-sided weakness, and speech disturbance associated with hemodynamic instability, and chest pain. Thoracic aortic arch dissection was observed on CT angiography (CTA). In addition, CTA revealed that the dissection extends proximally into the left common carotid artery, left subclavian artery, brachiocephalic trunk, and right common carotid artery and distally to the left common iliac artery, coupled with significant stenosis of the left common iliac artery. Proper management of blood pressure (BP) parameters is life-saving for the patient. Since our hospital did not offer cardiothoracic surgery services, the patient was transferred to a different institution, where he received medical care immediately from an expert team and had surgery.