Dissecting aneurysm is the most common acute disease of the aorta. Men are more likely than women to develop aortic dissection. One-third of the cases show neurologic manifestations, which may be a clue to early diagnosis. Cerebral, spinal cord and peripheral nerve ischemia can occur. In general, the treatment of choice for dissection originating in the ascending aorta is prompt surgical intervention. Medical therapy to lower elevated blood pressure and to reduce the force of myocardial contractility is sufficient for dissection of the descending aorta.