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

J Stroke Cerebrovasc Dis. 2016 Jun;25(6):e86-8. doi: 10.1016/j.jstrokecerebrovasdis.2016.03.034. Epub 2016 Apr 12.

Abstract

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.

Keywords: Acute aortic dissection; Aneurysm; computed tomography angiography; subarachnoid hemorrhage.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Adult
  • Aortic Aneurysm, Thoracic / complications*
  • Aortic Aneurysm, Thoracic / diagnostic imaging
  • Aortic Aneurysm, Thoracic / therapy
  • Aortic Dissection / complications*
  • Aortic Dissection / diagnostic imaging
  • Aortic Dissection / therapy
  • Aortography / methods
  • Cerebral Angiography / methods
  • Computed Tomography Angiography
  • Embolization, Therapeutic
  • Humans
  • Intracranial Aneurysm / complications*
  • Intracranial Aneurysm / diagnostic imaging
  • Intracranial Aneurysm / therapy
  • Male
  • Subarachnoid Hemorrhage / diagnostic imaging
  • Subarachnoid Hemorrhage / etiology*
  • Subarachnoid Hemorrhage / therapy
  • Treatment Outcome