One old male patient was admitted to the hospital due to “consciousness disorders for 20 h”, with no presentation of chest distress, chest pain and abdominal pain. Emergency MRI demonstrated subacute focal infarction of left temporal-parietal gyri, physical examinations revealed the asymmetric blood pressure of  bilateral upper extremities, and aortic dissection was indicated by chest enhanced CT. Therefore, careful analysis of clinical manifestations and early diagnosis are important for treatment of aortic dissection among those with cerebral infarction as main presentation.