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A Hidden Catastrophe: Ruptured Abdominal Aortic Aneurysm Presenting as Acute Ischemic Stroke

Year: 2026

Type: article

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.

Source: Cureus

DOI: 10.7759/cureus.116531

Authors: Eric Malani, Lucy Maguire, Maxwell Blodgett

Institutions: Christiana Care Health System, Christiana Hospital, Thomas Jefferson University

Language: English

Topic: Aortic aneurysm repair treatments

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W7213674990