Foot drop as a harbinger of aortic occlusion

A man presented with foot drop and 2 months later an infrarenal occlusion of his abdominal aorta was discovered. Initial evaluation found no structural etiology for his nerve injury. His neurologic deficits progressed until gangrenous changes developed in his feet leading to the discovery of aortic occlusion. This case demonstrates that peripheral nerve injury in the legs may signal underlying large vessel occlusive disease. We discuss the localization and potential mechanisms of ischemic nerve injury.