Unilateral upper and lower limb ischemia mimics stroke: a case report

Area of Science:

• Vascular Surgery
• Neurology
• Emergency Medicine

Background:

• Stroke and acute limb ischemia (ALI) can present with overlapping unilateral symptoms, challenging initial diagnosis.
• Prompt differentiation is critical as both conditions require distinct and timely therapeutic interventions to prevent irreversible damage.
• Awareness of these potential diagnostic mimics is essential for clinicians managing patients with acute neurological or vascular events.

Observation:

• A 69-year-old patient presented with unilateral paresthesia, initially suspected as stroke.
• Despite a negative brain computed tomography (CT) scan, persistent evaluation revealed acute left-sided upper and lower limb ischemia.
• The patient had known atherosclerotic risk factors, a crucial piece of history.

Findings:

• The patient underwent successful surgical revascularization for acute unilateral upper and lower limb ischemia.
• The diagnosis of ALI was confirmed after excluding stroke through comprehensive examination and imaging.
• The patient experienced a satisfactory recovery and was discharged shortly after the procedure.

Implications:

• This case underscores the necessity of considering ALI as a stroke mimic, especially in patients with unilateral limb symptoms.
• Persistent diagnostic efforts and repeated reevaluations are vital for accurate diagnosis in complex presentations.
• Recognizing and managing rare conditions like unilateral ALI that mimic stroke can lead to successful treatment and improved patient outcomes.