Purpose: If a patient with aortic dissection (AoD) is inadvertently treated with thrombolytic agents, severe complications and poor outcomes are likely to ensue. We reported a case and postulated mandibular pain as warning sign for diagnosing AoD related stroke.
Case report: We report an 81-year-old woman presenting with left mandibular pain followed by left hemiplegia. Extracranial carotid duplex showed dissection of the right common carotid artery and chest CT angiography proved AoD. She did not have any typical chest or back pain.
Conclusion: AoD should be carefully considered in patients with acute ischemic stroke presenting with mandibular pain. A high clinical alert and urgent CT angiography may help identify AoD.