Getting to the root of this gardener’s sudden paralysis
He had undergone an aortic-valve replacement six months earlier
When a man presented to ED with acute-onset paralysis of the lower legs, doctors went about unearthing the rare cause.
The 53-year-old gardener also reported a two-month history of intermittent fevers and a bioprosthetic aortic-valve replacement six months earlier.
On examination, the patient was febrile and had numbness and paralysis in both legs, with non-palpable femoral pulses. He had no cutaneous lesions.
A CT angiography was carried out, revealing a 9cm ascending aortic pseudoaneurysm (see Figure A, arrow) and multiple emboli in the superior mesenteric artery, renal arteries, infrarenal aorta, and iliofemoral arteries.
