Introduction: Acute aortic dissection (AAD) is a serious and uncommon event. The clinical presentation generally includes thoracic or back pain. Painless aortic dissection is an extremely rare occurrence. Acute paraplegia is one of the neurological complications secondary to AAD. Although painful paraplegia is seen in 2% to 3% of AAD cases, painless paraplegia is a very rare event.
Case report: A 51-year-old man with a long term history of hypertension, presented with acute paralysis of the lower extremities, with no chest or back pain.
Conclusion: In presence of acute neurologic events, must always be investigated a vascular cause and, in these group of disease, the aortic dissection may be researched, although the pain wasn't present on occasion of the diagnosis.