Un syndrome vertébro-basilaire fugace révèle une dissection aortique étendue de type A évoluant à distance de l'événement initial

Aortic dissection of type A (ADA) are rare and remain a permanent threat of misdiagnose for the emergency doctor. The diagnostic suspicion relies on an accumulation of clinical and radiological clues. Thoracic pain is most frequent among the ADA classical symptoms. A minority of ADA presents with an initial stroke event and will not be accompanied by thoracic pain. We report the rare case of a patient complaining of transcient amaurosis and vertigo in which the cardiologist finds a 2-month-aged ADA during the echocardiography. We describe the atypical course of this patient and discuss the mechanism related to his syndrome. Finally, we formulate clinical and paraclinical measures that enhance the diagnostic of ADA while facing an isolated cerebral accident.