Abstract
Neuropathy is a disease affecting the nerves that can be caused by infectious, ischaemic, or autoimmune disease. Aortic thrombosis may develop neurologic symptoms; however, when unilateral paraplegia is the first main symptom, it could be misinterpreted as a neuropathy. An 82-year-old man with a history of intracranial haemorrhage complained of motor weakness in the right lower extremity. Magnetic resonance imaging did not show any evidence of cerebral infarction or haemorrhage. A subsequent computed tomography angiogram confirmed the diagnosis of an acutely thrombosed abdominal aortic aneurysm and revealed thrombosed common, internal and external iliac arteries bilaterally including the left femoral artery. Aortobifemoral bypass surgery with open thrombectomy was performed. The patient recovered successfully despite a tendency for bleeding due to the use of anticoagulants. In conclusion, this is a rare case with the initial predominant presentation being painless unilateral paraplegia mimicking stroke. (Hong Kong j.emerg. med. 2016;23:52-56)