text: <unk>  is classically abbreviated as IMH. It may occur as a primary event in hypertensive patients in whom there is spontaneous bleeding from vasa vasorum into the media or may be caused by a penetrating atherosclerotic ulcer.<unk><unk>  may also develop as a result of blunt chest trauma with<unk>  wall injury. Thought to begin with the rupture of the vasa vasorum, the blood vessels that penetrate the outer half of the<unk>  media from the adventitia and arborize within the media to supply the<unk>  wall. The<unk>  propagates along with the medial layer of the aorta. Consequently,<unk><unk>  weakens the aorta and may progress either to outward rupture of the<unk>  wall or to inward disruption of the intima, the latter leading to communicating<unk>  dissection. Unlike<unk>  dissection, no intimal flap is present. If it involves the ascending aorta, treatment is surgical to prevent rupture or progression to a classic<unk>  dissection. Conservative management is indicated for<unk> s of the descending aorta.
option_0: Aortic intramural hematoma
option_1: Aortic dissection
option_2: Aortic rupture
option_3: Iliac artery aneurysm
option_4: Penetrating atherosclerotic aortic ulcer
option_5: Coronary artery dissection
option_6: Left ventricular aneurysm
option_7: Coronary artery trifurcation