Acute aortic dissection is a challenging diagnosis for emergency physicians because of its high mortality and wide range of clinical presentations. We report a case of a previously healthy man who presented with hyperfamiliarity for faces syndrome as the predominant symptom of a large type A aortic dissection diagnosed by computed tomography angiography in the emergency department. Different elements of his presentation suggested possible other diagnoses, including transient global amnesia and transient ischemic attack. We discuss how evaluating these other diagnostic possibilities led to the correct diagnosis. Given increasing reports of painless aortic dissection, this case demonstrates the need to consider aortic dissection in patients with acute neurological symptoms.

急性主动脉夹层由于其高死亡率和广泛的临床表现，对急诊医生来说是一个具有挑战性的诊断。我们报告了一例既往健康的男性，他在急诊科通过计算机断层扫描血管造影诊断为大型 A 型主动脉夹层的主要症状，表现为面部过度熟悉综合征。他陈述的不同内容暗示了可能的其他诊断，包括短暂性全面失忆症和短暂性脑缺血发作。我们讨论评估这些其他诊断可能性如何导致正确诊断。鉴于无痛性主动脉夹层的报道越来越多，该病例表明有急性神经系统症状的患者需要考虑主动脉夹层。