Objective:

To describe the clinical characteristics and outcomes of patients with type A aortic dissection (TAAD) who initially presented with neurological symptoms and were first admitted to the neurology department due to these symptoms.

Approach:

Key Findings:

• Mean age of patients was 62.4 ± 12.2 years; 34.8% were women.
• Common symptoms included altered consciousness (65.2%) and limb weakness (56.5%); only 21.7% reported chest or back pain.
• Median D-dimer level was 22.73 mg/L (IQR, 9.13–61.17).
• 39.1% received intravenous thrombolysis before diagnosis; 17.4% underwent surgical repair.
• 65.2% died during hospitalization; long-term survival rate was 17.4%.

Interpretation:

Acute TAAD may mimic acute stroke, leading to misdiagnosis and inappropriate thrombolytic therapy. Atypical features such as altered consciousness and limb weakness should raise suspicion for TAAD.

Limitations:

• Single-center study may limit generalizability.
• Retrospective design may introduce selection bias.
• Small sample size may affect the reliability of findings.

Conclusion:

Atypical neurological symptoms in patients without chest pain should prompt consideration of TAAD.

Attribution Notice

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