Paraplegia caused by painless acute aortic dissection

Objectives: Painless acute aortic dissection in which paraplegia is the onl y presenting sign is rare, with limited reported cases. Case report: The authors report a patient with painless acute aortic dissec tion who presented with sudden onset paraplegia. Ischemic diseases of the s pinal cord were suspected as the cause. MRI revealed extensive acute aortic dissection with an intramural hematoma. The patient was treated conservati vely by strictly controlling his blood pressure. The treatment was successf ul, although the motor function of the lower extremities could not be rescu ed. Although 3% to 5% of patients with acute aortic dissection present with paraplegia as a result of spinal cord infarction, most of these patients e xperience severe pain prior to presentation. Conclusion: Painless acute aortic dissection in which paraplegia is the onl y presenting sign is very ran. However, aortic diseases, including acute ao rtic dissection, should always be considered as a differential diagnosis of patients with sudden onset, painless paraplegia.