Case Studies| Volume 25, ISSUE 6, e86-e88, June 2016

Concurrence of Aneurysmal Subarachnoid Hemorrhage and Stanford Type A Acute Aortic Dissection

      We report a rare case of concurrent aneurysmal subarachnoid hemorrhage (SAH) and acute aortic dissection (AAD). A 38-year-old man visited our hospital complaining of severe headache, and brain computed tomography (CT) revealed the presence of SAH. Thoracic to neck computed tomography angiography (CTA), performed in addition to brain CTA, suggested a tear in the aortic arch, and subsequent CT aortography established the diagnosis of Stanford type A AAD. The AAD in our patient, who reported no episodes of chest or back pain, was detected incidentally by thoracic to neck CTA. The imaging study has rarely been indicated for SAH except that it provides additional anatomical information in patients for whom extracranial–intracranial bypass surgery or endovascular treatment is considered. Nevertheless, our experience may highlight additional diagnostic value of thoracic to neck CTA in SAH patients.

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        • Blanc R.
        • Piotin M.
        • Mounayer C.
        • et al.
        Direct cervical arterial access for intracranial endovascular treatment.
        Neuroradiology. 2006; 48: 925-929
        • Elefteriades J.A.
        • Sang A.
        • Kuzmik G.
        • et al.
        Guilt by association: paradigm for detecting a silent killer (thoracic aortic aneurysm).
        Open Heart. 2015; 2: e000169
        • Kuzmik G.A.
        • Feldman M.
        • Tranquilli M.
        • et al.
        Concurrent intracranial and thoracic aortic aneurysms.
        Am J Cardiol. 2010; 105: 417-420
        • Regalado E.S.
        • Guo D.C.
        • Villamizar C.
        • et al.
        Exome sequencing identifies SMAD3 mutations as a cause of familial thoracic aortic aneurysm and dissection with intracranial and other arterial aneurysms.
        Circ Res. 2011; 109: 680-686
        • Okuda T.
        • Idomari K.
        • Arakaki Y.
        • et al.
        Subarachnoid hemorrhage and acute aortic dissection accompanying Marfan syndrome: a case report.
        Jpn J Neurosurg. 2003; 12: 445-447
        • Inaba S.
        • Iwata S.
        • Kayano T.
        • et al.
        Perioperative management of a patient with subarachnoid hemorrhage complicated with descending aortic dissection.
        Masui. 2005; 54: 680-682
        • Imamura H.
        • Sekiguchi Y.
        • Iwashita T.
        • et al.
        Painless acute aortic dissection: diagnostic, prognostic and clinical implications.
        Circ J. 2011; 75: 59-66
        • Inamasu J.
        • Hori S.
        • Yokoyama M.
        • et al.
        Paraplegia caused by painless acute aortic dissection.
        Spinal Cord. 2000; 38: 702-704