case_images: PMC11635539_01
case_images: Imaging examination results obtained following the patient's admission to the stroke alert protocol. A. The non-contrast head CT scan revealed unremarkable morphology of both cerebral hemispheres and the brainstem. Additionally, there was a focal area of mild hypodensity adjacent to the right lateral ventricle. B1. The cross-sectional image of the cranial CTA showed non-visualization of the right internal carotid artery. B2. The 3D reconstruction of the cranial CTA suggested occlusion of the right internal carotid artery. C1-C4. The CTP demonstrated reduced cerebral blood flow (C1) and cerebral blood volume (C2), prolonged time to drain (C3), and extended time to peak (C4) in the right frontal and insular lobes.
case_images: aaem-13-e18-g001.jpg
case_images: PMC11635539_01_aaem-13-e18-g001.jpg
case_images: F1
case_images: There was a patch of slightly hypodense material adjacent to the right lateral ventricle (Figure 1A). CT angiography (CTA) with 3D reconstruction revealed the absence of the right internal carotid artery within the intracranial space, and the left internal carotid artery and other intracranial arteries demonstrated a normal course with no evidence of significant stenosis or dilation (Figure 1B). CT perfusion (CTP) demonstrated reduced cerebral blood flow (CBF) and cerebral blood volume (CBV), prolonged time to drain (TTD), and extended time to peak (Tmax) in the right frontal and insular lobes (Figure 1C). 
case_images: Radiological findings of thoracoabdominal CT scan and thoracoabdominal aorta CTA. A1-A2. Thoracoabdominal CT scan revealed a dilated thoracoabdominal aorta with heterogeneous intraluminal density, suggestive of aortic dissection. B1-B5. Thoracoabdominal CTA cross-sectional images (B1-B4) and the corresponding 3D reconstruction (B5) revealed the presence of a Stanford type A aortic dissection, characterized by the separation of the aortic wall layers.
case_images: aaem-13-e18-g002.jpg
case_images: PMC11635539_01_aaem-13-e18-g002.jpg
case_images: F2
case_images: However, the thoracoabdominal CT scan revealed a widening of the thoracoabdominal aorta with heterogeneous intraluminal density (Figure 2A), suggesting the possibility of AD. The false lumen of the thoracic aorta was notably wider, with a transverse diameter of approximately 59 mm at its widest point, and exhibited wall-attached annular and crescent-shaped low-density filling defects (Figure 2B). 