Painless aortic dissection presenting as spinal cord ischemia.

A 67-year-old woman developed a transient paraplegia as the initial manifestation of acute aortic dissection. Chest or abdominal pain was not present. Magnetic resonance imaging of the thorax demonstrated dissection of the aortic root, aortic arch, and descending aorta as well as pericardial effusion. Ultrasonography of the abdomen revealed an intimal flap in the region of the artery of Adamkiewicz. During aortic dissection, temporary obstruction of spinal arteries may result in transient paraplegia. Painless aortic dissection should be considered in patients who present with transient myelopathy.