Introduction
Patients with acute aortic dissection (AD) and intramural hematoma (IMH)
can present with a variety of symptoms including cerebral ischemic in
addition to classical chest pain. Catastrophic outcomes in AD cases
mistakenly treated with tissue plasminogen activator (tPA) have been
reported [1-2]. It is crucial to rule out AD/IMH in stroke patients.
Moreover, treatment of type A IMH with stroke is controversial and our
case illustrates success with a delayed surgical repair.