Painless dissection of the thoracic aorta.

A 64-year-old man presented to an emergency department with a two-week history of intermittent, bilateral lower extremity paralysis without associated chest, abdominal, or back pain. He subsequently deteriorated and died as a result of a thoracic aortic dissection. This unusual case is reported, and the pathophysiology, diagnosis, and management of aortic dissection are discussed.