Aortic Dissection in a Young Woman: A Painless Presentation With Stroke-Like Symptoms and Horner’s Syndrome

Figures

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  Figure 1. Non-contrast CT of the head showing multiple low-attenuation lesions scattered throughout both cerebral hemispheres (white arrows) and in the periphery of the right cerebellar hemisphere, consistent with acute ischemic changes.

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  Figure 2. MRI of the brain demonstrating an area of acute ischemic injury (arrow) as one of several sites resulting from vascular compromise. Image quality is limited due to motion artifact.

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  Figure 3. TTE in the parasternal long axis view exhibiting the Stanford type A aortic dissection, with dilatation of the ascending aorta (measuring 4.5 cm). The white arrow points to the true lumen, and blue arrow points to the false lumen. LA: left atrium; LV: left ventricle; RV: right ventricle; AR: aortic root; AA: ascending aorta; TTE: transthoracic echocardiography

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  Figure 4. CT angiography of the chest, abdomen, and pelvis illustrating a Stanford Type A aortic dissection. The dissection flap extends into the brachiocephalic artery and proximal right common carotid artery, with partial occlusion of the proximal left common carotid artery. The ascending aorta is enlarged, measuring 4.5 cm in diameter (white arrow). The smaller more densely opacified true lumen is compressed anteriorly along the length of the descending thoracic aorta (blue arrow).

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  Figure 5. CT angiography showing the Stanford Type A dissection flap extending through the common iliac bifurcation into the left common iliac artery and its branches, including the left external and internal iliac arteries (white arrows).

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  Figure 6. CT angiography of the head and neck revealing the Type A aortic dissection extending into the bilateral common and internal carotid arteries, with near-total occlusion of the left internal carotid artery (white arrows). Image quality is limited due to motion artifact.