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Figure legends:
Figure 1. CT angiography of head and neck with contrast (A) and CT of
the head without contrast (B).
A. Thrombosis in the right internal carotid artery (Red arrow) and
intramural hematoma in the aortic arch (Yellow arrow). B. Initial
concern of large vessel occlusion in the right middle cerebral artery
(Red arrow).
Fig.2. CTA on day 0, day 5, and postoperative image.
A. An initial CTA demonstrated type A intramural hematoma (IMH) in the
ascending aorta just above the aortic root and extending as far as the
transverse arch proximal to the left subclavian artery. The size of the
ascending aorta was 5.1 cm. The distal arch and proximal descending
aorta were dilated to 5.4 cm.
B. A follow-up CTA on day 5 showed the ascending aorta was stable in
size. The size of IMH decreased from 10mm to 5mm.
C. Total arch replacement with frozen elephant trunk and previous
endovascular stent graft for abdominal aortic aneurysm.