Fig. 10

Aneurysmal dilatation of the aorta secondary to dissection variant IMH in a 66-year-old woman. a Oblique sagittal contrast-enhanced CT demonstrates IMH extending from the ascending aorta through the proximal descending aorta. b Axial image depicts a streak-form ulcer-like projection (primary intimal tear) in the descending aorta (arrowhead). c Two days after onset, an ulcer-like projection was enlarged to form an outpouching cavity into the thrombosed false lumen (small arrow). d One week later, the haemorrhagic content is resolved and the ulcer-like projection not been detected. On the other hand, the aorta shows aneurysmal dilatation. Note that the dilatation starts from the location where the haematoma was present (large arrow). Although the pathological features and clinical course are different, such aneurysmal dilatation of dissection variant IMH might be confused with an atherosclerotic aortic aneurysm if an ulcer-like projection is not detected on the initial CT examination