Seyma AYKAC, Esra ASIKDOGAN, Sena AKGUL, Bedriye KARAMAN, Celal CINAR
Neurological Sciences and Neurophysiology - 2026;43(1):53-55
Acute aortic dissection (AAD) represents a critical vascular emergency caused by a separation of the aortic wall layers, which allows blood to enter a false lumen due to degeneration of the media. Without prompt diagnosis and intervention, the condition carries a rapidly increasing risk of death, making early identification essential for patient survival. Depending on the dissection's extent and anatomic involvement, neurologic manifestations can arise, including ischemic stroke, spinal cord infarction, hypoxia-induced encephalopathy, or peripheral neuropathies. When classic signs such as chest or back pain are absent, AAD can mimic primary neurologic diseases, delaying appropriate diagnosis. This diagnostic challenge can be further complicated by multiorgan dysfunction, which may obscure the vascular cause. We report a previously healthy middle-aged male who developed sudden painless paraparesis and hepatorenal dysfunction following a syncopal episode, who was ultimately diagnosed with having a DeBakey type I aortic dissection extending to the iliac bifurcation. This case underscores the importance of recognizing atypical neurologic or systemic signs suggestive of AAD, particularly in the absence of pain.
