Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

Non-contrast CT (not shown) shows a cuff of high attenuation around the aortic lumen in the acute phase that is low attenuation on post-contrast CT.
Case Discussion
Aortic intramural hematoma is an atypical form of aortic dissection due to hemorrhage into the wall from the vasa vasorum without an intimal tear.
Intimal calcification may be displaced inwards. Echocardiography and MRI may also detect the abnormality but conventional angiography will not. The two main differential diagnoses are a thrombosed false lumen in classic aortic dissection, and aortitis.
Credit: Dr Donna D'Souza.