A morbid coexistence: thrombosed descending thoracic aorta aneurysm and aortic insufficiency with aortic diastolic reverse flow
A 76-year-old woman presented with difficulty in speech and weakness on right arm and leg. Her medical history was remarkable only for uncontrolled hypertension for a long period. Dysarthria, right central facial paralysis, right hemiparesis and hypoactive deep tendon reflexes were noticed on neurological examination. Moderate degree aortic insufficiency with aortic diastolic reverse flow was detected on transthoracic echocardiography. Thrombosed aortic aneurysm on descending thoracic aorta, and an acute hemorrhagic infarction in the distribution of the left middle cerebral artery were depicted on thorax, and brain computed tomography scans, respectively. Cerebrovascular event was medically managed and whereas conservative management was offered for thrombosed descending thoracic aorta aneurysm.