Painless transient paraparesis as the solitary manifestation of aortic dissection

We present a 62-year-old man with acute and temporary paraparesis of the lower extremities as the solitary symptom of an anterior spinal artery syndrome caused by a type B aortic dissection. Ischemia of the spinal cord was confirmed by magnetic resonance imaging. Neurologic symptoms resolved completely within 6 hours and conservative treatment was successful up to 8 months follow-up. Our report illustrates that painless, transient neurologic deficit can be the only presenting symptom of acute aortic dissection and that aortic dissection should be part of the differential diagnosis of acute paraparesis.