Painless aortic dissection should be considered in the differential diagnosis of acute neurologic syndromes, particularly when accompanied by pulse deficits or characteristic chest x-ray changes.
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Supports considering painless aortic dissection in neurologic differentials with pulse deficits; case reports leave open need for prospective validation.
We describe three patients who had painless dissections of the aorta which resulted in neurologic syndromes at the time of presentation. Two patients had acute hemimotor and sensory findings. In one of these cases progression to paraplegia occurred. In a third patient, acute weakness and ischemia of a leg occurred at presentation. We review previously described painless aortic dissections. Such aortic dissections may be suspected in the setting of an acute neurologic event by abnormalities in the examination of the peripheral pulses and the heart and by attention to characteristic chest x-ray changes.
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Gerber et al. (1986) studied this question.
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