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.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of Stroke and Cerebrovascular Diseases
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Direct cervical arterial access for intracranial endovascular treatment.Neuroradiology. 2006; 48: 925-929
- Guilt by association: paradigm for detecting a silent killer (thoracic aortic aneurysm).Open Heart. 2015; 2: e000169
- Concurrent intracranial and thoracic aortic aneurysms.Am J Cardiol. 2010; 105: 417-420
- 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
- Subarachnoid hemorrhage and acute aortic dissection accompanying Marfan syndrome: a case report.Jpn J Neurosurg. 2003; 12: 445-447
- Perioperative management of a patient with subarachnoid hemorrhage complicated with descending aortic dissection.Masui. 2005; 54: 680-682
- Painless acute aortic dissection: diagnostic, prognostic and clinical implications.Circ J. 2011; 75: 59-66
- Paraplegia caused by painless acute aortic dissection.Spinal Cord. 2000; 38: 702-704
Published online: April 12, 2016
Accepted: March 18, 2016
Received in revised form: March 8, 2016
Received: January 14, 2016
The corresponding author (J.I.) received a research grant from the Japan Society for the Promotion of Science (JSPS KAKENHI Grant Number 26462173).
© 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.