Key result
Isolated frontal headache masks type A aortic dissection successfully treated with aortic root replacement.
Case Report (n=1)
No
Stanford type A aortic dissection can present atypically as a migraine-like headache, highlighting the need for cardiovascular workup in patients with Marfan-like features.
Atypical migraine aura may signal SAAD in young adults; leaves open whether imaging thresholds should expand beyond classic symptoms.
Stanford type A aortic dissection (SAAD) is a fatal condition in which patients often present with severe chest or back pain that radiates along the direction of propagation. In this report, we present the first published case of a patient complaining of migraine with aura as an initial manifestation of SAAD without the typical chest pain, back pain, or neurologic deficits. A 35-year-old, tall, male, night-shift taxi driver with a history of migraines arrived at the emergency department complaining of a slow-onset frontal headache that he attributed to migraine. Intravenous acetaminophen administration with fluid infusion did not improve his symptoms. An electrocardiogram showed ST depressions and a transthoracic echocardiogram showed severe aortic regurgitation with an aortic flap. He was diagnosed with Marfan syndrome complicated by SAAD and underwent surgical aortic root replacement. Aortic dissection may have a variety of initial manifestations; cardiovascular workup should be considered for migraine patients, especially those with Marfan-like features.
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Aoki et al. (2021) conducted a case report in Stanford type A aortic dissection (n=1). Aortic root replacement was evaluated on Patient outcome. A 35-year-old male presenting with only a frontal headache and a history of migraines was successfully diagnosed with Stanford type A aortic dissection and treated with aortic root replacement.
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