CTICasesAcute Type A Aortic Dissection with Malperfusion and Stroke
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Imaging findings
Extensive Type A aortic dissection involves the ascending aorta, with the false lumen showing extremely slow flow and poor opacification, mimicking complete thrombosis. Concurrently, there is complete occlusion of the right common carotid artery, accounting for the patient's presentation with a massive stroke.
Key takeaways
Acute Type A aortic dissection is a life-threatening emergency, often complicated by malperfusion syndromes. Extremely slow flow within the false lumen can be challenging to differentiate from complete thrombosis but can lead to severe organ ischemia. The origin of the intimal tear can be difficult to pinpoint, raising questions about a proximal tear versus retrograde propagation from a distal tear.
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