A Hidden Catastrophe: Ruptured Abdominal Aortic Aneurysm Presenting as Acute Ischemic Stroke.
- 1Emergency Medicine, Christiana Care Health System, Newark, USA.
- 2Neurocritical Care, Thomas Jefferson University, Philadelphia, USA.
Abstract
A ruptured abdominal aortic aneurysm (AAA) is a life-threatening emergency that typically presents with hypotension or abdominal pain but rarely with primary neurological deficits. We report the case of a 74-year-old woman presenting with acute focal neurological deficits concerning for ischemic stroke, whose preceding abdominal pain and lower extremity mottling ultimately pointed toward an alternative diagnosis. Point-of-care ultrasound and subsequent computed tomography angiography revealed a ruptured infrarenal AAA. We discuss how consideration of these additional clinical features led to the correct diagnosis and prevented inappropriate thrombolytic therapy. Given the time-sensitive nature of stroke management, this case highlights the importance of maintaining a broad differential diagnosis and considering aortic pathology in patients presenting with acute neurological symptoms.
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BibTeX
@article{malani2026hidden,
title = {{A Hidden Catastrophe: Ruptured Abdominal Aortic Aneurysm Presenting as Acute Ischemic Stroke.}},
author = {Eric Malani and Lucy Maguire and Maxwell Blodgett},
journal = {Cureus},
year = {2026},
month = sep,
doi = {10.7759/cureus.116531},
url = {https://europepmc.org/article/MED/42899157},
note = {CC BY},
}
RIS
TY - JOUR
TI - A Hidden Catastrophe: Ruptured Abdominal Aortic Aneurysm Presenting as Acute Ischemic Stroke.
AU - Eric Malani
AU - Lucy Maguire
AU - Maxwell Blodgett
PY - 2026
DA - 2026/09/19
JO - Cureus
DO - 10.7759/cureus.116531
UR - https://europepmc.org/article/MED/42899157
AB - A ruptured abdominal aortic aneurysm (AAA) is a life-threatening emergency that typically presents with hypotension or abdominal pain but rarely with primary neurological deficits. We report the case of a 74-year-old woman presenting with acute focal neurological deficits concerning for ischemic stroke, whose preceding abdominal pain and lower extremity mottling ultimately pointed toward an alternative diagnosis. Point-of-care ultrasound and subsequent computed tomography angiography revealed a ruptured infrarenal AAA. We discuss how consideration of these additional clinical features led to the correct diagnosis and prevented inappropriate thrombolytic therapy. Given the time-sensitive nature of stroke management, this case highlights the importance of maintaining a broad differential diagnosis and considering aortic pathology in patients presenting with acute neurological symptoms.
SN - 2168-8184
ER -