Abdominal Aortic Pathology Revealed by Cauda Equina Syndrome

tion studies were normal and the recruitment was reduced in several myotomes in needle electromyography (EMG). An aorto-aortic endoprosthesis was implanted. Afterwards, he went to the rehabilitation Dear Sir, Sixty percent of all arterial aneurysms involve the abdominal aorta, 75% of which occur in the infrarenal location [1] . Complications can include urinary or venous compression, ischemia by thromboembolic mechanisms or hemorrhage as a result of a rupture. According to the literature, neurological complications that occur in the perioperative or postoperative period are rare. We report 3 cases of patients who presented initial neurological symptoms as a result of aortic aneurysms. Patient 1 . A 61-year-old man with history of smoking (30 pack-years) and chronic alcohol abuse presented with acute motor and sensory deficits in the lower limbs. Clinical examination revealed a complete motor deficit of the left lower limb and a partial motor deficit of the right lower limb. The patient suffered from cruralgia and hypoesthesia of the left lower extremity. His deep tendon reflexes and the Babinski sign were absent. The anal reflex was diminished, but no saddle block anesthesia was observed. The distal pulses were not palpable. Lumbar medullar magnetic resonance imagery without diffusion (MRI) was normal except for a infrarenal abdominal aortic aneurysm measuring 7 cm in diameter, which was also visible on an abdominal computed tomography scan (CT scan; fig. 1 ). Three days later, electromyography confirmed peripheral involvement: F-waves were absent, nerve conducReceived: June 12, 2009 Accepted: January 10, 2011 Published online: March 11, 2011