Can a blocked artery cause leg symptoms that look like a spinal nerve emergency?

Details

This single-patient case report describes a 67-year-old man with a history of stenting in both iliac arteries who presented with sudden right-leg weakness, numbness, and severe pain after exertion. Femoral and distal pulses were absent on both sides. During the initial evaluation, clinicians suspected cauda equina syndrome.

However, computed tomography angiography of the abdomen and pelvis revealed an acute thrombotic occlusion of the distal abdominal aorta extending into both common iliac arteries, with a 3.1-cm aneurysm.

Emergency vascular intervention consisted of over-the-wire thrombectomy and endovascular stenting, with adjunctive balloon angioplasty. Blood flow to both lower extremities was restored. On postoperative day one, strength and sensation had normalized, and distal pulses were palpable. The patient's lower-extremity symptoms and neurologic deficits resolved completely.

The case emphasizes the importance of clinical awareness, rapid diagnosis, and urgent treatment of an acute vascular condition that can mimic cauda equina syndrome.