LAUSR

A 74-year-old woman presented to the emergency department with acute chest pain radiating to the back. As acute aortic syndrome was clinically suspected, computed tomography (CT) angiography was performed. Immediately after performing the arterial-phase scan, the patient suddenly became lethargic and developed transient focal seizure-like involuntary movement in the left upper extremity. Her blood pressure was 80/60 mmHg. The delayed-phase scan was obtained at a delay of 150 seconds from the beginning of contrast injection. After performing complete scans, she returned from the CT room and recovered well by volume administration. On precontrast CT examinations, a crescent-shaped area along the wall of the aorta, which showed higher attenuation than that of the blood, was detected (Figure 1A). The arterial-phase CT scan demonstrated an acute proximal intramural hematoma (IMH) (Figures 1A and 1C) with an ulcer-like