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- Occlusion of distal aorta
- embolic occlusion
- saddle embolism
- ventricular thrombus
- accident & emergency medicine, cardiology
- vascular medicine
A patient in their mid 50s presented with a history of sudden-onset pain in the lower limbs. Shortly afterwards, the patient started having paraesthesia around the saddle region and cold legs. There was a medical history of hypertension, and a recent thrombophilia screen was positive.
The patient was referred to the neurosurgical team for assessment. Neurological examination revealed a power of 3/5 in both legs globally, brisk knee jerks, absent ankle jerks, and plantars were downgoing. There was also pins and needles and decreased sensation in the saddle area, with normal anal sphincter function. Urgent whole-spine MRI showed no evidence of compressive myelopathy. Vascular examination revealed absent femoral, popliteal and pedal pulses in …
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.