Traumatic common iliac artery occlusion mimicking acute sciatica: a case report

Lower extremity numbness, pain, and weakness after trauma are often attributed to neurological causes such as lumbar disc herniation or spinal injury. However, vascular injuries may present with similar symptoms and lead to diagnostic confusion. We report a 61-year-old woman who developed progressive numbness and weakness of the right lower extremity after a traffic-related fall onto the right hip. Lumbar magnetic resonance imaging showed L5 endplate fracture and degenerative spinal changes, initially suggesting a neurogenic cause. However, physical examination revealed pallor, coldness, and absent distal pulses in the affected limb, raising suspicion of arterial occlusion. Computed tomography angiography confirmed complete occlusion of the right common iliac artery. The patient underwent endovascular angioplasty with stent placement, which restored arterial flow and resulted in rapid symptom resolution. This case highlights an important diagnostic pitfall and emphasizes the importance of careful pulse examination when post-traumatic neurological symptoms are accompanied by limb ischemia.