Aortic dissection should be considered in the differential diagnosis for patients presenting with acute onset headaches when no intracranial source is identified.
Acute headache without intracranial source may rarely indicate aortic dissection; this single case leaves open its diagnostic yield in unselected patients.
Aortic dissection is a life-threatening medical emergency often presenting with severe chest pain and acute hemodynamic compromise. The presentation of aortic dissection can sometimes be different thus leading to a challenge in prompt diagnosis and treatment as demonstrated by the following presentation and discussion. We present a case of a 71-year-old male who presented to the emergency department with complaints of left sided temporoparietal headache and was eventually diagnosed with a thoracic aortic dissection involving the ascending aorta and descending aorta, with an intramural hematoma in the descending aorta. This case illustrates the importance of keeping in mind aortic dissection as a differential diagnosis in patients with acute onset headaches in which any intracranial source of headache is not found.
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Parikh et al. (2015) studied this question.
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