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[This article belongs to Volume - 70, Issue - 9]
Published on : 2025-09-11 19:24:27
Article Code: AMJ-11-09-2025-12337
Title : Unexplained Neurological Deficit and Impaired Vascular Perfusion: A Subtle yet Critical Indicator of Aortic Dissection in a District Hospital Setting
Author(s) : Sofia Ivanova
Abstract :
Acute aortic dissection can present with a diverse range of clinical signs and symptoms. It is a condition
with high morbidity and mortality that could be missed without a high index of suspicion. This case
examines a 45-year-old gentleman who presented to a district hospital with hemodynamically unstable,
acute right-sided body weakness associated with a fall the day prior. He also reported frank haematuria,
with suprapubic, pelvic, and right thigh pain for the past three days. A preliminary diagnosis of cerebral
vascular accident with a need to rule out intracranial bleeding was made, and he was arranged for an
urgent computed tomography brain scan at a secondary hospital. Unfortunately, he eventually succumbed
to cardiac tamponade secondary to aortic dissection. This case highlights the challenge clinicians face in
identifying a vascular emergency that disguises with a history of trauma. This challenge is further amplified
in hospital settings with scarce resources and expertise. Therefore, a thorough history taking, a focused
physical examination, and a high index of suspicion are crucial for making an accurate diagnosis.