Headache: an unusual presentation of aortic dissection

Area of Science:

• Cardiovascular Medicine
• Neurology
• Medical Diagnostics

Background:

• Aortic dissection is a life-threatening condition often presenting with severe chest pain.
• Hypertension is a significant risk factor for aortic dissection.
• Typical initial symptoms include chest pain, but atypical presentations can occur.

Observation:

• A patient with a history of hypertension presented with a severe bifrontal headache.
• This headache was the initial and primary symptom.
• The patient was diagnosed with acute aortic dissection.

Findings:

• The aortic dissection occurred without any associated carotid artery dissection.
• The presentation of headache as the sole initial symptom is rare for aortic dissection.
• This case underscores the variability in clinical manifestations of aortic dissection.

Implications:

• Clinicians should consider aortic dissection in patients presenting with severe, unexplained headaches, even without typical symptoms.
• Understanding atypical presentations is crucial for timely diagnosis and improved patient outcomes.
• Further research into the pathophysiology of headache in aortic dissection may be warranted.