Painless acute aortic dissection with a left hemiparesis: a case report.

We report a patient with completely painless acute aortic dissection who presented with transient left hemiparesis. A 59-year-old male presented to our Emergency Department with left-sided weakness of sudden onset. We therefore suspected cerebrovascular accident. A computed tomography scan of the head did not show any abnormal findings; however, the patient's neurologic symptoms disappeared suddenly, and he recovered fully. We therefore considered the diagnosis of transient ischemic attack. However, immediately thereafter, the patient's neurologic symptoms returned. The cycle of symptom appearance and recovery recurred 3 times over a period of a few minutes. The final diagnosis was acute aortic dissection (DeBakey type II Stanford type A). Completely painless acute aortic dissection who presented with only neurologic symptoms, which made the diagnosis of acute aortic dissection extremely difficult.