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.